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Jan 01 2013

2013: The Year of Healthcare Emancipation?

By e-patients, healthcare industry, healthcare price transparency, participatory medicine

Hang on to your hats – this one might wade into controversy. As I write this (3:30pm EST on January 1, 2013), I’m listening to a conversation on NPR about the Emancipation Proclamation, which was signed into law by Abraham Lincoln 150 years ago today. I’m also reflecting on a couple of movies I’ve seen in the last 45 days: Lincoln (over Thanksgiving weekend) and Django Unchained (on Christmas Day). Is it time for an emancipation proclamation for patients? Or should we just saddle up and have a shootout at the plantation … um, hospital instead? Too many healthcare transactions are still conducted over the patient’s supine form. Doctors, hospitals, and other entities in the “provider” column horse-trade with health insurers, including Medicare, in the “payer” column. That means that the patient winds up shackled. No say in how much something costs, no real voice (yet) in what happens next, little interest on the part of the two trading entities in clueing us in to what’s happening. Some of my connections in the participatory medicine/e-patients movement use a driver-rider metaphor for transforming healthcare, with the patient moving from passenger to driver in healthcare. It’s a less controversial/confrontational metaphor than referring to patients as chattel on the medical plantation. However, I’m sticking with that plantation metaphor for the moment, because too many in the provider and payer camps are still viewing patients as meat puppets, not as full participants. Does healthcare need an emancipation proclamation? Yes. Here’s where the metaphor shifts: let’s not wait for someone to proclaim us (patients) emancipated. Let’s break our own chains, and be our own liberators. Let’s demand that the providers and the payers give us an equal seat at the table, and then let’s … LEARN EVERYTHING WE CAN TO BE PRODUCTIVE CONTRIBUTORS TO THE HEALTHCARE SYSTEM. That last statement is…

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Jan 01 2013

2013 Manifesto: short and salty-sweet

By healthcare industry, technology

Last year’s look-ahead for 2012 was a 5-point manifesto. Reviewing progress against that list, I see that I did pretty well, with only #2 falling a little short – which is not a bad track record. This year, I’m keeping it tight. I’m going with a 2-rule manifesto. Rule #1: Be accountable We’ve all got metrics to measure ourselves against. Revenue, connections, sales, errors, accomplishments – all of those are important. The trouble comes when you focus too much on one area, which usually means that other important metrics wind up taking a back seat. If you focus exclusively on incoming revenue, you might miss some mistakes that will cost you at least some of that revenue. If you concentrate only on building more connections in the industry, you might lose some long-term relationships that are just starting to ripen. For me, accountability this year will be tied to two metrics: raising the revenue gained from the speaking side of my business, and widening my marketing net beyond the mid-Atlantic region. Tracking both will be easy, and each will challenge me to focus very tightly on activities and outreach that will move my game-plan forward. Accountability – at least here at Mighty Casey Media – will be baked in to the spreadsheet I’ll use to track that game-plan. What accountability will you bake in to your 2013 goals? How will you track your progress? Who will you report to? That last one is a challenge for me, since I’m a solo-preneur. Stay tuned, since one of my accountability check-boxes will be reporting progress here, on the Mighty Mouth Blog. Rule #2: Laugh more, bark less That’s a purposeful scrambling of the “wag more, bark less” bumper sticker I see … everywhere. My version of wagging is laughter. If I’m laughing,…

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Dec 25 2012

More motion on mobile health

By healthcare industry, technology

I spent a day last week at Rutgers University in the company of some heavy hitters in mobile healthcare. I’ll be posting a full report soon on Disruptive Women in Health Care, but in the meantime, here are some highlights: “More people have mobile phones than have toothbrushes,” said Tom Wheeler of the mHealth Alliance (not good news if you get stuck in an elevator or on a subway with someone in the only-mobile-phone group) “Delight drives change” was an observation made by Dr. Gopal K. Chopra, the founder of pingmd, about what will drive successful mhealth ideas mHealth Gazelles was a phrase used (coined?) by Ernst & Young Entrepreneur in Residence David Shrier in his presentation about how venture capital can empower the growth of mHealth “Technology is the only path away from the drive off the cliff.” That was one of Joe Carr’s comments (he’s the CIO of the NJ Hospital Assn.) during a panel discussion about the market-readiness of mHealth – he was referring to the fact that healthcare costs are literally bankrupting the nation “The economic model of healthcare is institutionally perverse.” Al Shar, CIO of the Robert Wood Johnson Foundation, said that … and is HE right there or what? “We must kill the silos.” Jayant Parthasarathy, the Director of Innovation and R+D at United Health Care … another “is he right or WHAT?” moment It’s the user experience, stupid. No one actually said that, but it was the subtext of almost every panel. Including the one that I participated in, which made the local business pages the next day As I said in the opening graf, watch this space for an update when the full report hits Disruptive Women in Health Care in the coming weeks. And tell me what mobile health apps you use, or you dream of – I really do want to know, and I really will help bring them to life.

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Dec 24 2012

Immediate Jeopardy: I’ll take Medical Errors for $100,000!

By e-patients, healthcare industry, participatory medicine

Accountable care. That’s one of the central pillars of healthcare reform/Obamacare/the Affordable Care Act. Given that Obamacare is built on transforming Medicare, the payment system from which all Holy Billing Codes and the pricing attached thereto flow, Accountable Care Organizations (ACOs) would seem, given their name, to be about accountability for care, right? Not so fast. The “accountable” in ACOs has more to do with accounting than accountability. An ACO is defined as a network of doctors and hospitals that shares responsibility for providing care to patients. In essence, that network agrees to manage all of the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years. The ACO is indeed accountable for providing care, yet that 5,000-Medicare-beneficiaries-for-three-years is as much about accounting as it is about patient care. Real accountability in healthcare is an elusive thing. I’ve said many times that there are no guarantees in medicine, other than that there are no guarantees in medicine. That does not mean, though, that we should expect mistakes. Medicine is a human effort, with human failings embedded within it. We should help ourselves, and the medical-industrial complex, though, by taking advantage of the information available to us – patients, providers, all of us – to determine where to get the best and safest care. jeopardy clue tileAccountability, in the accountable-actions definition, was codified in a California law that went into effect on January 1, 2007. That law gives the California Dept. of Public Health the power to fine hospitals up to $100,000 per event for what they call “immediate jeopardy”, which is defined thus: An immediate jeopardy is a situation in which the hospital’s noncompliance with one or more requirements of licensure has caused, or is likely to cause, serious injury or death to the patient….

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Dec 18 2012

“How much is that?” = quest for VALUE

By healthcare industry, healthcare price transparency

When you’re shopping for something, sometimes price is the only consideration. Yet think about the times when price matters, but you’ve already determined the only brand or brands you’re interested in buying. Let’s say you’re buying a car. You’ve done plenty of research, using the criteria that are important to you. Fuel economy, vehicle safety statistics, passenger/cargo capacity, style, color – your vehicle-value-determining checklist. Only after you’ve built that list will you start to hone in on price, shopping around to find the dealers that have what you want in your price range. Value is only fully visible when you know what  you’re getting for the price. Even in something as simple as grocery shopping, price isn’t always the #1 driver of purchase decisions. Sure, for some things generic Brand X at rock-bottom price is the way to go … on things like shop towels. However, ask any Coupon Queen what her quest is all about, and she’ll tell you that it’s about brands, then it’s about price. She’s not clipping coupons for generics, unless it’s a store brand that meets her quality metrics. Price is important. Value is critical. In the “how much is that?” campaign in healthcare, we’re as concerned about quality as we are about price. In healthcare there are quality metrics that far outstrip those for consumer products, but many of those healthcare quality metrics have been hard for consumers – patients – to find and use in assessing healthcare value. That’s changing with the rising availability of quality metrics like the Hospital Safety Scores from The Leapfrog Group released at the end of November. The US Department of Health & Human Services’s Agency for Healthcare Research and Quality – that’s a mouthful (and a massive amount of information on one site), let’s stick with HHS’s…

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Nov 29 2012

Comedy writer way-back machine: That ****ing tree

By Uncategorized

I spent 20+ years working for NBC at 30 Rock. When I started exploring stand-up comedy, the first bit I wrote was based on my experiences working in the building behind what has become “America’s Christmas Tree” – or, as I came to call it, “that fucking tree”. Since the thing was lit last night, I know the hell my former colleagues are going through. Here’s the bit, in its entirety, with one update for 2012: Who’s really jazzed about Christmas? Who’s excited beyond words at all the decorations and the hoopla? Well, I know one thing about all of you. You don’t work in 30 Rock. I do. That fucking tree. Imagine that your commute, which normally means pinballing across at least one train platform and at least several crosstown blocks, now also includes hacking your way through a literal mob of tourists. The mob grows by the minute. You’re trying desperately to get to your office. You can see the revolving doors across the plaza, but … There’s the Stroller Army, who aim at your knees and ankles as they press their little angels closer to that fucking tree. There’s the Double-Wides, who stand tall as they wave their arms, pointing … right into your eye … at that fucking tree. You’ve got the tour group from Thailand, in scattered clumps around the skating rink, wai-ing that fucking tree. So you make your best broken-field run across the heaving horde, focused on those doors and what’s beyond them – black coffee, toasted bagel, dry, and your work day – and you have to join in on a chorus of When the Saints Go Marching In (Gangnam style!) just to achieve the lobby. I tell you, there’s nothing about that fucking tree that couldn’t be cured with a can…

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Nov 21 2012

Healthcare a passion of yours? Win an award!

By e-patients, healthcare industry

WEGO Health is an online network of people from across the globe who use the internet and social media to connect around health and share health information. WEGO calls us Health Activists, and they’ve  created a special awards program to recognize those Health Activists who are making a real difference in the online health community: click here to find out all about it. Health Activists are doctors, patients, caregivers, family members, any and all folks who care about their own health and the health of their families and communities. I’ve signed up to be an Awards Ambassador – that means that I’m doing what I can to share the WEGO Health Activist Awards with my audience to make sure that all Health Activists are recognized for the efforts they make every day. Take a spin over to the nominations page and recognize your favorite health leaders. There is no limit to how many people you can nominate so make sure to recognize everyone that you follow, fan, or friend. WEGO Health has 12 different categories so everyone should fit somewhere! Is there someone who inspires you to get and stay healthy? Is there someone whose online presence helps you manage a chronic condition? Is there a healthcare professional in your life who has guided you, your family, or your community toward better health with their work on the web? Nominate ’em! There is no limit to how many people you can nominate so make sure to recognize everyone that you follow, fan, or friend.  WEGO Health has 12 different categories, so there’s a slot fo any kind of online Health Activist! So go on – NOMINATE!

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