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Help us, IBM-Dell-Apple. You’re our only hope.

March 16, 2016 by Mighty Casey Leave a Comment

I’ve been on the road a lot over the last six months, getting the chance to interact with (and, I hope, influence), audiences in health tech and health policy. There’s so much desire for change, search for innovation, and just straight up “desperately seeking [something]” out there, it’s almost hilarious that no real change/shift/what-have-you has yet occurred in the giant $3-trillion/year-and-rising sucking sound that is the American healthcare system.

Which is why I concluded, long ago, that the system would not be re-invented from within, particularly when it comes to the tech side of the party. Since the medical-industrial complex is keeping the fax machine manufacturers of the universe in business, it’s hard not to snort with laughter at tech “innovations” that emerge from inside the complex’s ivory towers.

Tech innovation – on both the consumer and the system side – will come from companies with a proven history of delighting ground-level customers. The ones I like to call “people.” Here’s a Casey-ism that will be appearing in a new report on tech in healthcare from The Beryl Institute:

“My sense about technology, and whether it’s engagement or system improvement or anything in this zone, I think that the change is going to come from outside the healthcare industry. The solutions are going to be delivered by companies or entities that have a history of putting technology in the hands of consumers (people) and having those consumers (people) say ‘awesome!’ and just start using it.”

I don’t think anyone – consumer or clinician – has touched anything related to Electronic Health Records (EHR) tech and said anything resembling “awesome” about the experience.

ehr-no-one-ever

We, as a nation, have thrown $30+ billion at getting our healthcare delivery system into the 21st century, but have so far only seen it get to the point where it’s partying like it’s 1995 (Windows 95 – it’s AWESOME! Not.). Data exchange, a/k/a “interop,” is still a distant dream, which is why I have a QR code tattooed on my sternum as a political statement. “I am my own HIE,” essentially.

What we need here is a “1984” moment in healthcare. Not the George Orwell book, but the Mac computer ad that ran on Jan. 22, 1984 during the third quarter of the Super Bowl.

Epic Systems won’t deliver it. As much as Jonathan Bush would like athenahealth to deliver it … nope. Our “Obi Wan only hope” is going to have to come from a company that’s got a track record – distant or current – of delivering into the hands of consumers easy-to-use tech that has them saying “awesome!” and then … just using it.

ibm-dell-apple-3-way
“Help us, IBM-Dell-Apple. You’re our only hope.”

Which is why I’m saying “help us, IBM-Dell-Apple, you’re our only hope.” I’m not including Google, because they’ve already tried/failed, with GoogleHealth, and then (IMO, stupidly) abandoned the healthcare vertical after one play.

IBM might seem like an odd player to include here, but I know what they’re up to at the Serious Games lab at UNC under gamer-grrl extraordinaire Phaedra Boinodoris. (The Medical Minecraft project is of particular note there.)

Dell is in the personalized-medicine space, particularly in pediatric cancer, where they’ve built the Neuroblastoma and Medulloblastoma Translational Research Consortium (NMTRC) as a tumor board tool across 25 universities and children’s hospitals looking to build some real precision medicine/faster cures to fight children’s brain cancer.

Apple is the only player to serve up an actual consumer device with health apps – the iWatch and the ResearchKit, which turns an iPhone into a research contribution engine for a variety of projects looking at conditions from autism to breast cancer to Parkinson’s disease.

People, consumers, are ready (desperate?) to engage with the healthcare system using the same digital tools they use daily to manage everything from soccer practice to shopping lists to banking: their smartphones. The challenge to the healthcare system is to make tools to make that possible … which they have utterly failed to do, to date.

It’s time to hand the problem to proven consumer-delighters.

“Help us, IBM-Dell-Apple. You’re our only hope.”

Filed Under: Business, Entrepreneurs, Find the funny, Healthcare, Media commentary, Politics, Storytelling, Technology, Women in Business Tagged With: digital health, e-patients, health care, Healthcare, mighty casey media, mobile, mobile apps, participatory medicine, smartphones

The State of Health Information Exchange: Benefits and Challenges

August 26, 2014 by Mighty Casey 1 Comment

graphic of tablet with EKG

This is a guest post by TechnologyAdvice.com writer Jesse Jacobsen. TechnologyAdvice.com is based in Nashville, TN, and their stated mission is to provide valuable insight to business technology buyers, while creating connections with the products and vendors that best meet those buyers’ needs. Their site is a goldmine of industry-specific intel on current software and IT products and trends … and they have a dedicated healthcare tech content channel!

graphic of tablet with EKGAccording to the 2013 HIMSS Analytics Report, 73 percent of respondents indicated they were participating in health information exchange (HIE), with 57 percent only participating in a single HIE. Of the practices in an HIE, 52 percent reported experiencing benefits with better access to patient information, 20 percent experience promoted patient safety, and 12 percent said HIE led to time savings among clinicians. Only 16 percent reported no benefits.

As evidenced above, HIEs can be effective tools for improved practice operations, but that doesn’t mean the system is foolproof. In the same report from HIMSS, the top challenges faced by hospitals included other organizations not sharing enough data (49 percent), lack of necessary staff (44 percent) and resources (40 percent), and privacy concerns (39 percent).

As government mandates continue to push provider use of electronic medical records (EMRs) and HIEs, more practices are beginning to consider if it’s time to participate in a health information exchange. The following will look at some of the current benefits from HIE participation and address some current challenges.

Benefits

Better Patient Information

HIEs provide physicians with easier access to patient information, especially on a state level, such as the recently implemented HIE in Florida. Currently, accessing patient information can be a costly and inefficient process, with too much reliance on faxing and email. Utilizing an information exchange makes gaining patient data a quick process with far fewer expenses.

Reduced Imaging Duplication

By reducing duplication of diagnostic tests, physicians can heavily reduce expenses and increase practice efficiency. According to a study from the University of Michigan, around 20 percent of all scans performed by emergency department clinicians were considered repeats. When hospitals used HIEs, patients were 59 percent less likely to have a redundant CT scan, 44 percent less likely to get an additional ultrasound, and 67 percent less likely to have a repeated chest X-ray. Eliminating such duplication can result in significant cost savings for providers, patients, and payers.

Improved Care and Reduced Errors

Simply put, when doctors have quick and easy access to patient records, they can make informed and effective treatment decisions. Without access to this information, physicians are basing diagnosis and treatment decisions on a narrow view of their patient’s health history. With quick access to a longitudinal view of a patient’s health history, physicians can see current and past prescriptions, previous diagnoses, reactions to medications, and any other pertinent information. This information is essential when prescribing medication to ensure that new prescriptions won’t adversely interact with current medication that patients are taking. Between 26 and 32 percent of total medication errors are caused by administrative errors. These are potentially fatal mistakes that can easily be prevented with proper HIE implementation.

Use in Emergencies

For patients in emergency situations, time is of the essence. Being able to access patient information from HIEs helps clinicians act quickly and responsibly. In 2009, the average time spent being treated in emergency rooms was four hours and seven minutes, an increase of 27 minutes since 2002. Increased treatment time in the ER results in increased wait times, which on average took six hours in 2009. ER doctors can decrease patient interaction and wait times with quick and easy access to patient records from HIEs, including information on allergies, past treatments, pre-existing conditions, and applicable test results.

In addition, emergency departments can use HIEs to reduce expenses and unnecessary admissions. According to a study conducted by Weill Cornell Medical College, the chances of a patient being admitted to the hospital was 30 percent lower when the HIE was used, leading to estimated annual savings of $357,000. Decreasing unnecessary admissions also results in shorter wait times.

Challenges

Security Concerns

A report published by the Bipartisan Policy Center found that 25 percent of clinicians cited privacy and liability concerns as barriers to participating in health information exchanges.  The argument behind these security concerns is logically sound; if HIE affiliates have increased ease of access to patient information, who else might have this increased access as well? How can we be sure that sensitive patient and practice information is secure? After all, HIPAA violations are quite expensive.

While this concern is justified, most HIE affiliates recognize this potential shortcoming and have established a wide array of policies to prevent any information leaks. For example, when electronic requests for patient information from a healthcare provider are made from an unknown provider, most HIEs refuse to provide any data. As these platforms for data exchange continue to advance and increase in adoption, more policies and safeguards will be put into place to ensure the security of patient files.

Inconsistent or Insufficient Information

Many healthcare providers who have already integrated HIEs into their practice complain that insufficient patient information and inconsistent filing methods are a huge hindrance to HIE success. Data fragmentation is already an issue for the healthcare system as a whole, costing up to $226 billion per year.

Unfortunately, this is a challenge will take time and continual effort to alleviate. As more hospitals and practices begin sharing data, and as the government groups continue to establish detailed, reasonable standards for patient records, data silos will be broken down.

Insufficient Funds

For many providers, developing HIE networks makes very little sense strictly as a business investment. According to a study from the Robert Wood Johnson Foundation, 74 percent of respondents listed developing a sustainable business model as a moderate or substantial barrier to HIE deployment, in addition to a high level of concern about a lack of funding (66 percent).

To tackle this issue, some practices are joining cloud-based HIEs, which charge monthly fees, alleviating the heavy upfront costs typically incurred by other systems. These pay-as-you-go systems can become more expensive than their counterparts however when used for a long period of time. Additionally, transferring patient information through the cloud presents a potential security concern. But, for cash-strapped practices seeking a means to effectively exchange data, a cloud-based community could be the answer.

Lack of Infrastructure

Similar to lacking proper funding, many healthcare providers list a lack of infrastructure as a major challenge with HIE. A survey from Doctors Helping Doctors Transform Health Care found that 71 percent of respondents listed lack of infrastructure as a primary challenge. Adding infrastructure is not only expensive because the infrastructure itself is pricey, but also because the labor and resources required to outfit new systems are expensive as well.

Again, selecting a cloud-based solution can alleviate many infrastructure shortcomings. Cloud systems require very little on premise infrastructure to gain access, and accordingly require minimal labor investment to setup. While building the proper infrastructure to maintain a normal HIE is recommended, cloud-based options are growing in popularity and accessibility, making it a viable solution for smaller practices and struggling health care providers.

HIEs are far from perfect, but the information and resources they provide can add value to practices everywhere. Unfortunately, many of the improvements that need to happen to HIEs simply require time and commitment from a large volume of healthcare providers. The technology is there, and eventually the commitment and investment from practices will be as well.

Filed Under: Business, Entrepreneurs, Healthcare, Storytelling, Technology

Smokin’ deal. Brand/Social media audit. Get 2013 started right, CHEAP!

December 11, 2012 by Mighty Casey Leave a Comment

smoking hot stuff
smoking hot stuff
make your brand smokin’ hot!

It’s almost 2013.

Want to set your brand storytelling on fire for the New Year?

Looking to get your branding on social media in sync and hotter than Christmas in July?

Longing to create some emotional heat in the hearts of your customers?

Here’s how you can get 2013 off to a smokin’ hot brand-storytelling start, at a bargain-basement price:

Brand / social audit deals from Mighty Casey Media!

Here’s how it works.

  • Want a brand audit? 
    • I do a full website copy review
    • You get a written report with specific suggestions on:
      • Brand story opportunities
        • Are you telling the best story possible?
        • Are there holes in your story?
      • Website copy improvements
        • Too many words?
        • Not enough words?
        • Words that don’t work?
      • Newsletter editorial calendar outline for 2013
        • Monthly and quarterly tips to increase your email newsletter’s open rate
  • Want a social media audit? 
    • I do a full social media platform review (including your company blog)
    • You get a written report with specific suggestions on:
      • Content creation/curation for the social platforms you use
        • What to share
        • Where to share it
        • Content sources that will amp up your social story-telling
      • Social platforms that could add brand engagement
        • Are there social opportunities you’re missing?
      • Blog editorial calendar outline for 2013
        • Tips for making your weekly posts eyeball magnets for your target audience

OK, I know you have a question:

How much is it?

That’s easy.

$250 each.

Want to get both?

$400 if you buy both.

(That’s a $100 savings, in case your calculator’s broken.)

The catch? There are only 10 of each available.

If you want to take advantage of this deal, here are the steps:

  • Decide you want to buy
  • Email me with your web and/or social links by Monday, December 31, 2012

That’s it!

You’ll get your written report by January 9, 2013, along with a PayPal invoice.

Simple.

So what are you waiting for?

GO!

 

Filed Under: Business, Entrepreneurs, Social media, Storytelling, Women in Business Tagged With: brand, brand audit, branding, Business, entrepreneurs, fire sale, mighty casey media, Social media, social media audit, Storytelling

Did Warren Buffett really say THAT?

March 27, 2012 by Mighty Casey Leave a Comment

no-labels-movement

Well, it turns out he did.

What did he say? Hang on. I’ll get there in a sec.

First, I’ve been silent here for a while (holy crap, I haven’t posted since Jan. 31!) – my only excuse is that I’ve started blogging for clients, and ran out of words. Not really, but that’s my story, and I’m stickin’ to it.

Back to our programming already in progress: Did Warren Buffett really say THAT?

WHAT DID HE SAY?

Well, he said this (on CNBC in July last year), kids:

“I could end the deficit in 5 minutes. You just pass a  law that says that anytime there is a deficit of more than 3% of  GDP, all sitting members of Congress are ineligible for re-election.”

no-labels-movement
No Labels. Not left. Not right. FORWARD.

Boo-yah! This is essentially what my buddies at No Labels have been saying since they released their 12-point plan to make Congress work back in December. #1-with-a-bullet of those 12 points is No Budget, No Pay. Which, by the way, had a subcommittee hearing earlier this month. Progress. It’s a game of inches, but we’re racking up those inches.

Speaking of fighting for inches, the healthcare reform act – or Obamacare, whatever your radio tells you that you should call the Patient Protection and Affordable Care Act – is in oral-arguments phase in front of the Supremes this week. I’m on record as thinking that this iteration of healthcare reform isn’t anything but an attempt at healthcare *payment* reform, but that’s not why I brought this up.

If you care about controlling healthcare costs – your own or anyone else’s – you must read e-Patient Dave deBronkart’s latest epic opus on what happens when a healthcare consumer tries to find out what something costs. The insurers don’t know, the hospitals sure as **** don’t know, so what’s a patient to do? Keep asking. Keep demanding answers. Keep it up until we all get healthcare to post its rates clearly, and in public.

I promise not to go quiet again. You can guarantee that by leaving a comment, or sharing this post.

Ready, set … GO!

Filed Under: Business, Entrepreneurs, Find the funny, Politics Tagged With: "Cancer for Christmas", casey quinlan, disruptive women in health care, e-patient dave, e-patients, health care, health care reform, Healthcare, media, mighty casey media, no labels, politics, Social media, warren buffett

It’s the education, stupid …

January 23, 2012 by Mighty Casey Leave a Comment

State of Education infographc

The headline on this post is inspired by both the 1992 Clinton campaign meme, and by my personal belief – shared by many – that education in the U.S. is in trouble, and will sink us if we don’t act decisively and quickly to change a broken system.

State of Education infographc
(c) OnlineEducation.net

The infographic tells the story. You can click it to open up the source in a new tab, and get the full weight of the problem broken down pretty darn well.

Some high(low?)lights:

  • only 30% of U.S. students in K-12 are grade-proficient in math and reading
  • 70% (that’s SEVENTY PERCENT, my friends) of 8th graders can’t read at grade level
  • Every 26 seconds, an American kid drops out of school (can you say “brain drain”?)
  • There are only 50 million skilled workers in the U.S. – there are 123 million skilled job openings (still wonder why jobs get outsourced?)
  • In Finland, South Korea, and Singapore, teachers are drawn from the top 1/3 of college graduates. In the U.S. they’re typically from the bottom 1/3 of college graduates. Looks like the old cliché “those that can’t, teach” might be true?
  • Newly-minted lawyers in the U.S.  make, on average, $115,000 per year more than a newly-minted teacher here. Newly-minted engineers and lawyers earn less than teachers in South Korea and Singapore. Is that math you can understand?
  • The U.S. comes in at 30th in math, 23rd in science, and 17th in reading when stacked up against global competition.

Is the picture starting to become clear to you? We’re in trouble, not just right now, but our future’s looking pretty dim, too.

If we can’t educate our children at a level that makes them – and our society – competitive globally, we’re looking like Rome after the lead poisoning set in: bleedin’ dim, and getting dimmer.

Dim and dimmer, that’s us!

The fix should be to put more muscle – in time, in talent, in treasure – behind education. But you and I both know that our fiscal cupboard is bare, and there’s little will in Congress – or money floating around on K Street – for teachers when defense spending is so much more … fun. I mean, education money doesn’t buy sexy new fighter jets, or aircraft carriers to keep those Somali pirates in line. Boo yah!

Uh, guess what? We’ll run out of money to build fighter jets and aircraft carriers if we don’t educate our kids to figure out better ways to build them.

That’s just one industry: defense.

What about healthcare, the hottest topic of the last decade? Rising costs there are bankrupting families, and could bankrupt the country, if we don’t have the smarts to solve the problem

Our middle-tier rankings in science and math education spell doom there, too.

If government isn’t going to take up the challenge, due to budget constraints and broke-ass-ness, who will? Is it time to evaluate a non-public option, and invite American enterprise to invest in charter schools across the U.S. to help us get back to the top of the Best & Brightest List?

Weigh in now. It’s almost too late, kids.

That’s my story, and I’m stickin’ to it …

 

Filed Under: Business, Entrepreneurs, Politics Tagged With: Business, casey quinlan, education, education gap, mighty casey media, politics, society, STEM education, teachers

Why is business expected to pay for healthcare in the US?

October 31, 2011 by Mighty Casey 4 Comments

image of gold caduceus casting shadow of dollar sign

I’ve asked this question frequently over the years, starting in the ’80s, continuing to today … and I’ll keep it up until someone realizes that it’s a failed paradigm.

What we have here, kidz, is what happens when a society decides that socialism is anathema, but doesn’t empower and educate its citizens about how to take responsibility for themselves in ways that will keep them healthy, productive community members.

Business started picking up the tab for healthcare during World War II, when stiff wage controls made it impossible for defense plants to give their employees raises. In place of more money, they started to pay for health insurance – which state and federal government were more than happy to turn into mandated employee benefits over the next 20 years.

What happened then was predictable: three generations have been out of touch with the true cost of  healthcare, and the true cost of their choices about their health. If you’re a good little American consumer, you do whatever your television tells you to do: eat this. Buy that. Otherwise the terrorists win!

Three generations of disconnection from the real costs of our medical care have delivered us an epidemic of obesity – thanks to plentiful empty calories, courtesy of agri-business, and our willingness to beach ourselves on our sofas, in our SUVs, or at our computers, the better to receive more messages about what we should buy and eat.

Health insurance costs have skyrocketed as we’ve become a nation of couch potatoes. Companies are scaling back their employee health benefits as those costs continue to rise, putting more and more people in the un-insured or under-insured bucket. Is that rise in healthcare costs, which in turn drives higher premiums, combining with the federal mandate that all companies offer employees health insurance or face the wrath of Khan, er, the feds the real “job killer”? I think so.

Here’s a suggestion: sell health insurance like auto, home, and life insurance are sold. Put consumers in charge of shopping for, and purchasing, their own insurance. Let business help their employees, if they choose to do so, as a true benefit rather than a mandate. Help every consumer set up a Health Savings Account for their healthcare expenses. And stop the state-by-state divvy-up that lets health insurers essentially gerrymander the health insurance marketplace.

Put consumers fully in charge of their insurance, and their care. Turn the health insurance market into a car-insurance model. People can buy minimum levels of insurance, and assume the risk of that choice. They can opt out completely, and assume all the risk for their healthcare costs. Make it a true marketplace, rather than the giant mess that we currently call health insurance. Employers are certainly able to help their employees with HSA deductions and matching contributions; smart companies will help their teams figure out managing and negotiating for insurance as a group. But they shouldn’t be expected to foot the bill.

Radical? Perhaps. Necessary? I’d say it’s essential.

Until we’re put in touch with the costs of our healthcare, we won’t be encouraged/empowered to take control of our health. As long as we’re using other people’s money to pay for healthcare, we’re stuck where we are.

Which is a very bad place to be.

That’s my story, and I’m stickin’  to it …

Filed Under: Business, Entrepreneurs, Healthcare, Social media, Storytelling Tagged With: Business, casey quinlan, e-patients, education, employment, entrepreneurs, health care, health care reform, health insurance, Healthcare, mighty casey media, Social media, Storytelling

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