Just a reminder, the $3 million Heritage Health Prize competition will kick off on April 4. Sponsored by the Heritage Provider Network in Southern and Central California, the competition is meant to promote innovation in predictive modeling and clinical decision support, with the goal of helping physicians develop care plans to keep high-risk patients healthy and out of the hospital.
In a story I wrote for Inside Healthcare IT (formerly Inside Healthcare Computing) in January, I explained that HPN will provide contestants with three years worth of de-identified claims data on 100,000 patients, from which they are expected to develop algorithms to identify high-risk patients. “We’re looking for an algorithm to allow us to predict, based on a person’s history, the likelihood of a person’s hospitalization over the next year,” HPN legal counsel and executive Jonathan Gluck told me.
The Office of the National Coordinator for Health Information Technology today opened a four-week comment period on proposed revisions to the Federal Health IT Strategic Plan (pdf). Last updated in 2008, the plan spells out ONC’s strategy for meeting national health IT goals for the five-year period beginning in 2011. The HITECH Act requires this revision.
According to a blog post by national coordinator Dr. David Blumenthal:
Some components of the Plan may already be familiar, including the Medicare and Medicaid Electronic Health Record Incentive Programs and the grant programs created by the HITECH Act, which are creating an infrastructure to support meaningful use. However, the Plan also charts new ground for the federal health IT agenda:
In Goal I, the health information exchange strategy focuses on first fostering business models that create health information exchange, supporting exchange where it is not taking place, and ensuring that information exchange takes place across different business models.
In Goal II, we discuss how integral health IT is to the National Health Care Quality Strategy and Plan that is required by the Affordable Care Act.
In Goal III, we highlight efforts to step up protections to improve privacy and security of health information, and discuss a major investment in an education and outreach strategy to increase the provider community and the public’s understanding of electronic health information, how their information can be used, and their privacy and security rights under the HIPAA Privacy and Security rules.
In Goal IV, we recognize the importance of empowering individuals with access to their electronic health information through useful tools that can be a powerful driver in moving toward more patient-centered care.
In Goal V, we have developed a path forward for building a “learning health system,” that can aggregate, analyze, and leverage health information to improve knowledge about health care across populations.
ONC is accepting comments through April 22 via the blog site.
The slams on Dr. Donald Berwick, frankly, are getting pathetic.
Today, Fox News medical contributor Dr. Marc Siegel dismissed Berwick as a “basically a policy wonk” who “hasn’t really practiced since 1989.” Siegel tried to score points with sound bites. “This guy has more quotes than Yogi Berra, and let me tell you something, these quotes are an indictment on people that want clinicians to make decisions,” Siegel said on Fox this afternoon.
According to Siegel, comparative effectiveness “doesn’t work in the real world.” Well, sure, that’s the point of clinical decision support. Best practices are for common conditions, and clinical decision support is to help physicians either follow best practices in the case of common conditions or, just as importantly, diagnose and treat ailments that they don’t often see. (Read Dr. Atul Gawande’s best seller, “Complications,” for a description of the chaos that ensues when physicians see rare cases.)
Fox News anchor Megyn Kelly tried to feign fairness by saying of President Obama’s recess appointment that installed Berwick as CMS administrator last year, “lots of presidents do it.” But she later said that that Berwick “loves” the British National Health System, trying to paint Berwick as a socialist. Once again, this isn’t about socialism or capitalism or any other ism that has unfortunately been the focus of “health reform” in this country. It’s about trying to improve the quality of care. (It’s not about insurance, no matter how many politicians or pundits say so.)
Defending Berwick was Dr. Cathleen London, a family practitioner at the Weill Cornell Iris Cantor Women’s Health Center in New York City. London took issue with Berwick’s opponents relying on sound bites to make their thin arguments. (Siegel smugly laughed this off.)
When Kelly again tried to tie Berwick to the NHS, London said, “He likes that we do evidence-based medicine, that the British have NICE that actually oversees what the NHS should cover and shouldn’t.” Yes, the British National Institute for Health and Clinical Excellence (NICE) is an independent advisory board that helps the NHS make coverage decisions. You know, the same way any insurance system, public or private, has to decide what and what not to cover.
To his credit, Siegel praised Berwick’s work at the Institute for Healthcare Improvement for helping to reduce deaths in hospitals. “He’s apparently very well liked among patient safety advocates,” Kelly added.
London noted that former CMS Administrator Tom Scully, a George W. Bush appointee, is a fan of Berwick. Still, Siegel continued on his argument that comparative effectiveness is restributive in that it takes healthcare away from some people. “You’re not going to be able to pay for very expensive care,” Siegel said.
Why exactly would we want very expensive care in cases where less expensive but equally effective treatments are available? Is it because of the public perception that more expensive care automatically means better care? It sounds like Siegel is either trying to perpetuate that myth or protect the profits of pharmaceutical and device manufacturers. But then he made the salient point that “insurance is overused” and that healthcare reform, which he derides as “ObamaCare,” did little to address that problem.
All that says is that both sides of the political debate are wrong, and the Senate Democrats are cowards for not standing up for better care.
Satirical newspaper The Onion (“America’s Finest News Source”) is on its game once again. Many of you probably have already seen the story from last week, headlined, “Quick-Lube Shop Masters Electronic Record Keeping Six Years Before Medical Industry.” (I tweeted about it over the weekend and some other healthcare blogs have posted it.)
“We figured that a basic database would help us with everything from scheduling regular appointments to predicting future lubrication requirements,” said the proprietor of the local oil-change shop, Karl Lemke, who has no special logistical or programming skills, and who described his organizational methods, which are far more advanced than those of any hospital emergency room, as “basic, common-sense stuff.” “We can even contact your insurance provider for you to see if you’re covered and for how much, which means we can get to work on what’s wrong without bothering you about it. The system not only saves me hundreds of thousands of dollars per year, but it saves my customers a bundle, too.”
“In other words, we’re so pathetic that a bunch of young joke writers in NYC who almost never go to the doctor have noticed,” the insightful Michael Millenson notes via email. Millenson also points out that this is not the first time The Onion has made light of quality problems in hospitals. He referred to a 2005 article with the headline, “‘Employees Must Wash Hands’ Signs Top Iraqi Hospital Wish List.” The story said, “‘We appreciate the bedding, laundry-sanitization equipment, window glass, penicillin, needles, wall-repair materials, and so on, but without clean hands, none of these mean anything.’ Al-Obaidi said the importance of hand-washing could not, unlike doctors and nurses, be overstressed.”
Yes, we’re so pathetic that a bunch of young joke writers who almost never go to the doctor noticed six years ago that hand-washing in hospitals can save lives. Yet, clinicians in the U.S. routinely slip up in this department. (Paging Don Berwick yet again!)
On Jan. 28, Ron Pollack, executive director of the liberal advocacy group Families USA, introduced President Obama at a Families USA event by saying, “Numerous presidents over many decades tried to secure health reform legislation that would move us toward high-quality, affordable healthcare for all Americans. You, Mr. President, actually achieved it.”
The crowd ate it up.
During the contentious debate over health reform in 2009 and 2010, countless lobbyists, pundits and politicians touted “quality healthcare” as a reason to pass the Patient Protection and Affordable Care Act. Some called for the same “Cadillac” health plans that members of Congress provided for themselves. Many opponents of the legislation countered by saying the U.S. already has the “best healthcare in the world.”
The problem was not one of philosophical differences. The problem was a misunderstanding of a basic fact: health insurance is not the same thing as health care.
Still, politicians keep making the same mistake over and over, and the mass media keep giving them a free pass.
Anyone in the healthcare industry knows that the United States does not have the best healthcare in the world. We have the most expensive care in the world. (Another myth often passed off as truth is that more care and more expensive care automatically equals better care.) Having a “Cadillac” health plan won’t assure you better care, either. Just ask the late Rep. John Murtha (D-Pa.), who, as a member of Congress had such a plan, but still likely died as a result of a surgical error last year.
Another such episode occurred last week. James C. Tyree, chairman and CEO of financial services firm Mesirow Financial, died Wednesday at the University of Chicago Medical Center at age 53. Though Tyree had stomach cancer and pneumonia, the official cause of death was an intravascular air embolism, the result of an improperly removed catheter. That’s one of the National Quality Forum’s so-called “never events.”
As the chief executive of a financial firm, Tyree no doubt had the resources and the insurance to get what some people might call “good, quality care.” He also happened to be on the board of the U of C Medical Center, the very same institution that was so proud of being named one of U.S. News and World Report’s best hospitals in America. Yes, even at the “best” hospitals, mistakes happen, and they happen to people with money and connections.
This is yet another reason why CMS needs someone with a long record of quality improvement, even at institutions with supposedly sterling reputations. Someone like Don Berwick.
If you haven’t already, I encourage you to read the defense of Berwick that I wrote last week so you understand why politics is hijacking better healthcare in America.
Many of us have spent the better part of a year trying to explain “meaningful use” to people inside and outside of healthcare, with varying degrees of success. It turns out I should have been paying attention to “meaningful yoose” instead, because the far-hipper-than-I Dr. Ross Martin spits truth in less than three minutes.
The sun is shining here in Chicago and the mercury is supposed to hit 60 degrees today for the first time in months. That could mean only one thing: Spring is in the air, and hope springs eternal, even for the star-crossed Cubs. Though it’s still spring training, noted Yankees fan Glenn Laffel of the Pizaazz blog is in midseason form as he hosts this week’s Health Wonk Review, with an all-star lineup of contributors.
My impassioned defense of Don Berwick makes the big-league roster among the sluggers (health policy), while health IT gets its due respect as a disruptive force by being categorized as the base-stealers.
Of note, longtime HIT blogger Shahid Shah, known as the Healthcare IT Guy, talks security. “I hear a lot of naive talk about how systems are secure because ‘we use SSL encryption’ or ‘we’re secure because we have a firewall.’ Anybody who’s been security and privacy work for more than a few months would know how false those statements are,” he writes. To continue the baseball analogy, it’s like a pitcher making a couple of light tosses over to first to keep the base runner honest, then leaving the next pitch out over the middle of the plate.
And now back to an afternoon of watching basketball, er, I mean, answering e-mail or something. o:-)
Looking for more commentary about another aspect of health IT? Don’t forget that I’m now a regular contributor to MobiHealthNews. This week, I comment on the rave reviews coming in for the iPad 2, particularly from the healthcare sector, and note the significance of Microsoft discontinuing its Zune digital music player, the product that never did gain much traction against Apple’s ubiquitous iPod.
While it looks as if the Android platform may be losing out to the iPad in healthcare, I say don’t call this one for Apple just yet, at least not until Research in Motion comes out with its BlackBerry PlayBook next month.
In case anyone was still thinking the Patient Protection and Affordable Care Act was an insidious plot for government to take over healthcare, here’s HHS CTO Todd Park—you know, the co-founder of athenahealth—talking at this week’s South By Southwest Interactive conference in Austin, Texas. In this video, Park echoes the sentiments of his former business partner Jonathan Bush from an interview Bush gave me at HIMSS last month in saying that the government’s job isn’t to innovate but rather to lay the foundation for the private sector to innovate.