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healthcare industry

Nov 04 2010

The Story on Healthcare IT: Creating Connections

By healthcare industry, technology

The highest and best use of IT in healthcare is to create strong, healthy connections between doctors and their patients. One of the most critical pieces of that is giving patients access – both to their health data, and to their healthcare providers – along with permission to engage. I wear two hats in the healthcare space: patient activist/advocate, and healthcare communications/media consultant. My healthcare-focused company WellCentrix is building a reputation for understanding both the business (doctors & other providers) and the customer (that would be the patients, not the insurers) side of healthcare. I attended the Virginia chapter of the Health Information & Management Systems Society’s annual conference last week, and posted a wrap-up report of what I heard there over two days of sessions. If you’re a patient – and we’re all patients, even doctors are patients – you might want to get some intel on what healthcare IT leaders are doing, thinking, and planning. Click HERE to find out!

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Jul 23 2010

NOTHING ABOUT ME WITHOUT ME

By e-patients, healthcare industry, healthcare price transparency

The last few weeks have been a cluster-dance of activity in the e-patient community. Actually, pretty much any week is a fast dance in the participatory medicine world, given the drive toward healthcare reform in the US. The loudest dance orchestra has tuned up around the controversy created when the American Hospital Association (AHA) posted its comments on the Phase 2 Meaningful Use (MU2) rules, which are part of the Patient Protection and Affordable Care Act (PPACA), a/k/a healthcare reform or Obamacare, depending on what your preferred nomenclature is. The bottom line: even though the Centers for Medicare and Medicaid Services (CMS) has made re-admissions to the hospital within 30 days after discharge a giant “we won’t pay you for that” red flag, the AHA stood up on its hind legs and said, regarding MU2, that they did not want to make records available to patients for 30 days post-discharge. Which seems to mean that the AHA is either totally OK with not getting paid for a re-admission within those 30 days, or they’re trying to use a giant hammer to kill the adoption of electronic medical records technology. A third explanation – and one that I think is actually what’s happening here – is that the last couple of years of massive IT deployment in healthcare has been really hard. And the policy wonks who wrote the comment for the AHA have little or no dealings with actual patients. Because anyone with a brain who works in healthcare knows that not empowering patients to manage their care is the best path to both bad outcomes and bankruptcy. If you’d like to read all about the issue, you should start with David Harlow’s Healthblawg e-Patient Dave Healthcare activist artist Regina Holliday (the Rosa Parks of patients’ rights)

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Apr 08 2010

The Sad Story About Joint Replacement (in the US, at least)

By healthcare industry, healthcare price transparency

A hip or knee replacement can offer people with chronic joint pain the chance to return to an active life. The potential promise of being pain-free, in some cases after decades of restricted movement, is a powerful incentive to arthritis sufferers around the world. I know from direct observation that not all joint replacements result in the patient returning to the dance floor, or the jogging track, or even the walking path. My dad had a hip replacement in 1996 that inserted the wrong appliance, leading to 18 dislocations in the ensuing three years. The issue was finally resolved with yet another surgery, paid for by Medicare and my father’s supplemental insurance. This was a doctor error, not an appliance failure. Imagine my surprise this past Saturday (April 3, 2010) at this piece in the New York Times, revealing that almost all manufacturers of artificial joints offer no warranty whatsoever to US consumers who wind up with defective products surgically strapped on to their skeletal structure. The dodge is facilitated by the way device manufacturers sell the implants: to the hospital, not to the patient. The skids on that dodge are further greased by the consulting fees paid to many surgeons by implant makers, giving those surgeons little impetus to bite the hand that feeds them. Here’s a chart for the visual learners: US device manufacturers who sell artificial joints overseas offer warranties in the countries outside the US where their implants are used. Why not here? One reason could be our tort-crazy system. Got a consumer complaint? Don’t try to work it out directly – hire a lawyer and sue the bastards. That does not, however, excuse the failure of medical device makers to offer any kind of warranty on their products. And it’s not excuse for their expectation…

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Feb 16 2010

A Modest Proposal (on Health Insurance Reform)

By healthcare industry, healthcare price transparency, politics

~ Casey Quinlan © 2010 [originally posted on the now-defunct Disruptive Women in Health Care blog, posted here for posterity.] I will admit to a bias on the subject of health insurance, and healthcare reform: I’m one of the millions of America’s uninsured. I’m female, over 50 (I told you, now I’ll have to kill you), and I was diagnosed with cancer in December of 2007. The first of those facts – being female – is the biggest dinger of the three when it comes to health insurance premiums. The reasoning there: women use more health services, starting in their teens and 20s and continuing through menopause. The second – my age – could signal a better rate, since women typically tail off in their use of healthcare in their mid-50s. However, the third fact – cancer within the last 10 years – gets me insurance coverage quotes of $2,000 per month, with a deductible between at $3,000 to $6,000 a year. For the math-challenged, that’s between $27,000 and $30,000 out of my pocket per year before insurance covers Dollar One. Since that amounts to much of my annual pre-tax income in each of the two years since Cancer Year – 2008 was the last year I had health insurance coverage – I’ve remained on the uninsured list. And developed some fierce opinions about the future of healthcare and health insurance in the US. The Patient Protection and Affordable Care Act, a/k/a “health care reform,” passed earlier this year includes some help for my situation…in 2014. Meanwhile, I’m managing to get the oral chemo meds I’ll be taking until 2013 (which cost $500 a month) with the help of a community clinic. And I’m keeping my fingers crossed that I stay as healthy as I was before the cancer diagnosis,…

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Nov 30 2009

Health Care Storytelling

By e-patients, healthcare industry, storytelling

In all the sturm und drang over the US health care system in the last couple of years – and the last many decades – one voice seems to be largely missing in the discussion. We’ve heard from health care providers – hospitals, doctors, et al. We’ve heard from insurance companies. We’ve certainly heard from politicians. We have not, however, really been hearing from patients, unless some disease sufferer with a story to tell to support the POV of a health care provider, an insurer, or a political position gets trotted to the microphone to tell his or her story. As social media rises as the brave new communication platform for any and all global-village ideas and events, health care is starting, sloooooowly, to dip its toe into social networking as a tool to get their message out. What we have not seen, though, is a lot of listening, other than the usual suspects listening to (and yammering at) each other. There are a number of community sites that have grown up around specific conditions and issues – Fran Drescher’s Cancer Schmancer community and Lance Armstrong’s LIVESTRONG efforts around cancer spring to mind. Microsoft has launched MyHealthInfo.com, and Google’s got Google Health. Patients are out there: on Facebook, on Ning, on Twitter, and other online community sites like SparkPeople.com. However, less than 20% of doctors are currently using technology to manage their patients’ medical records – given that resistance to technology, combined with the strictures of HIPAA (which I swear must mean Health Insurance Paying All Attorneys), it’s easy to see why the health care industry seems to be MIA in the Web 2.0 world. One of the reasons cited by health care providers for not using web tools to communicate with their patients is privacy concerns. That is a…

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Jan 05 2009

A Great Story On Healthcare IT

By EHR, health records, healthcare industry

In today’s Health Care Blog, David Kibbe MD and Brian Klepper PhD continue a discussion that they kicked off with an open letter to the incoming Obama administration in December about health care IT and electronic medical records (EMR/EHRs). Patients think that EMR/EHRs are the answer to their prayers – no more forms to fill out, no referral slips to carry around, hey-presto, it’s all on this flash drive. What Kibbe and Klepper point out is that’s just the tip of the iceberg: “…we are realistic about the problems that exist with health information technologies as they are currently constituted. As we described in our previous post (and contrary to some recent claims), most products are NOT interoperable, meaning licensees of different commercial systems – each using different proprietary formats – often find it difficult to exchange even basic health care information.” In other words, let’s not create a tower of Babel just because IT tools exist that will let us. There’s enough failure-to-launch across the medical-care sector now: forests of paper records that are a bear to manage, much less share; HIPAA standing like Colossus over every single one of those sheets of paper; and the rising tide of ‘perfect EMR solutions’ that have been developed in the last few years. There is no ‘perfect solution’ – what’s required is that healthcare realize that it’s an IT business, just as every other commercial sector has come to realize over the last decade. “…many health care professionals still think of health IT as a compartmentalized function within health care organizations. But health IT has increasingly become the glue between and across all health care supply chain, care delivery and financing enterprises. In the past, it was enough for health IT to facilitate information exchange inside organizations – in which case…

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Dec 28 2006

Firehose of healthcare cost resources

By healthcare industry, healthcare price transparency

I attended the 2nd edition of the bill conference in Richmond VA today (for the record, that’s Saturday, April 6, 2013), and wound up kicking off the talks with what’s become my core topic: #howmuchisthat, healthcare edition. That link goes to the hashtag’s home on Symplur, the healthcare hashtag registry that’s also a veritable time-sink of terrific healthcare thought leadership. Including healthcare data visualization. You’re welcome. Why is this a topic I care so much, and know so much, about? I believe that in all the hot air that’s been expended in the discussion about healthcare and healthcare reform in the US – and boy, howdy, is that some hot air! – very little shrift is given to how consumers (commonly called “patients”) can effect grassroots change themselves. The firehose below takes a wander through the history of US healthcare, particularly from the cost angle, and resources that the average human can use to start figuring out, ahead of time, how to assess the value (medical and fiscal) of their healthcare options. Here’s the firehose. Steve Brill’s epic TIME piece, Bitter Pill  pack a lunch, it’s the longest article TIME has ever published My take on where Brill missed the mark on his “fix this mess” recommendations A Feb. 12 post that raises Brill’s issue in what I think of as a great-minds-thinking-alike synergy My health econ guru Uwe Reinhardt’s Chaos Behind a Veil of Secrecy article in January 2006 edition of Health Affairs A post that includes intel on the RUC and the LA Times piece – both of which I mentioned in my verbal firehose A NY Times story on the unintentionally hilarious 2013 report in JAMA (Journal of the American Medical Assn.) on the wide disparity in pricing for hip replacements in the US – the RUC is an AMA committee! Society…

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