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Consumer engagement in healthcare is harder than it seems

Every time I hear a story about consumer empowerment in healthcare, I get optimistic that consumers really can make a difference in containing runaway healthcare costs. Then something comes along to make me think that it’s a pipe dream. I just had one such occurrence.

Trending on Twitter right now is the meme “#pricesthatshockyou.” Just for fun, I clicked. Right near the top I saw this:

Honestly, i don't know why the american gov't makes the people pay so much for medical bills. Its not always their fault #pricesthatshockyou

Uh, the American government doesn’t set the prices. Sure, CMS sets Medicare reimbursement rates that often serve as a model for other payers, but providers set the rates they charge. Whether you have insurance or not, the government doesn’t have much say at all on the list price for medical services. (Yes, regulation adds to costs, and Medicare sets the tone for the fee-for-service model that has resulted in ridiculous utilization patterns, duplication and the like, but I really don’t think we’re dealing with an actuary or healthcare finance professional in this particular tweet. This is an average citizen with no concept of how the system really works.)

The sad thing is, it’s been retweeted at least 10 times.

June 30, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

A new association for mobile health?

Last week, I was at the Mobile Health Expo in New York, where conference organizer Wendy Thomas announced plans to form a group called the Mobile Health Association. I cover this today in MobiHealthNews.

Will this fill a void or just create more confusion in an industry that already includes groups such as the American Telemedicine Association, the mHealth Initiative, the mHealth Alliance, the Wireless-Life Sciences Alliance, the Continua Health Alliance, the West Wireless Health Institute and a few others? Watch this video, read the MobiHealthNews story, then decide for yourself.

 

 

June 29, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

RIP, Google Health, doomed to fail from the start

It’s official, Google is in fact walking away from Google Health, the way overhyped, way underused personal health record platform. In a posting on the Google Blog today, Aaron Brown, Google Health’s senior product manager, said the company would “retire” Google Health Jan. 1, 2012. (Data will be available to download until Jan. 1, 2013.)

Google also decided to wind down another experiment, Google PowerMeter.

From the post:

When we launched Google Health, our goal was to create a service that would give people access to their personal health and wellness information. We wanted to translate our successful consumer-centered approach from other domains to healthcare and have a real impact on the day-to-day health experiences of millions of our users.

Now, with a few years of experience, we’ve observed that Google Health is not having the broad impact that we hoped it would. There has been adoption among certain groups of users like tech-savvy patients and their caregivers, and more recently fitness and wellness enthusiasts. But we haven’t found a way to translate that limited usage into widespread adoption in the daily health routines of millions of people. That’s why we’ve made the difficult decision to discontinue the Google Health service.

In the end, while we weren’t able to create the impact we wanted with Google Health, we hope it has raised the visibility of the role of the empowered consumer in their own care. We continue to be strong believers in the role information plays in healthcare and in improving the way people manage their health, and we’re always working to improve our search quality for the millions of users who come to Google every day to get answers to their health and wellness queries.

Google said it soon will install functionality to help current PHR users migrate their data to other services following the Direct Project protocol, in the spirit of “data liberation.” That’s nice, but data really needs to connect with EHRs, or doctors and patients simply won’t use PHRs. Period.

I’m also going to take issue with Google referring to Google Health and Google PowerMeter as “trailblazers in their respective categories.” Google didn’t blaze any trails in PHRs. Dozens of other, smaller companies that have been working on the concept of PHRs for a decade or more are the real trailblazers.

The bottom line on Google Health? Google came into healthcare arrogantly believing it could save healthcare from itself and be all things to all people. (See also: WebMD, circa 2001.) It leaves with its tail between its legs.

Healthcare really does need disruptive outside forces, but it has to be a product people want to use. The iPad qualifies. Google Health never did, nor has any other untethered PHR to date.

 

 

 

June 24, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Epocrates building EHR for small practices

Has this been reported before, or have I just not been paying close enough attention?

Yesterday at the Mobile Health Expo in New York, Sean Handel, vice president of subscriber business at Epocrates, said that the San Mateo, Calif.-based company known for its mobile medical reference tools, is building an EHR for small physician practices. “A significant portion of that product will be a patient portal,” Handel said.

Handel also said to expect to see more integration of mobile apps into clinical systems as more people shift to tablets from traditional PCs. That’s no surprise. We have so little integration now that it really can only go up.

While I’m being slightly cynical, I leave you with this thought from Google’s Dr. Roni Zeiger:

Vocera's CEO points out: in 1980s only MDs and drug dealers had pagers. Drug dealers have upgraded.
@rzeiger
Roni Zeiger
June 23, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Does Berwick *really* sound like a radical commie?

While people continue to demonize CMS Administrator Dr. Donald Berwick and President Obama essentially throws Berwick under the political bus, far too many are missing the message. Wouldn’t “radical communist thugs” like one commenter on this YouTube page labeled the Obama administration really want to dehumanize patient care?

Watch this short video of Berwick speaking in Berlin in 2009 (yes, socialist Europe). He talks about how patient care already has been dehumanized and how healthcare professionals and organizations routinely ignore the wishes of patients. Speaking of a friend who couldn’t get mammogram results over the phone, Berwick said, “Their choice trumps her choice. Period. And that’s what scares me. It scares me to be made helpless before my time, to be made ignorant when I want to know, to be made to sit when I wish to stand, or to be alone when I need to hold my wife’s hand, or to eat what I do not wish to eat, or to be named what I do not wish to be named, or to be told when I wish to be asked, or to be awoken when I wish to sleep.”

Does that sound like a “radical communist thug” or someone genuinely committed to improving the quality of care and actually humanizing the patient experience?


 

June 19, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

EMR and HIPAA:EMRs, ICD-10 pave the way to business intelligence

That’s the subject of my weekly post on EMR and HIPAA, based on two stories I’ve written in the last 24 hours and a conference I attended last week in Madison, Wis. Check it out.

 

June 16, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

A public official with a sense of humor

It’s a good thing not all public officials are all work, no play. I’ve said for a couple of years that the tag team of federal CTO Aneesh Chopra and HHS CTO Todd Park are the anti-bureaucrats. (If you ever get a chance to see them speak together, take it.)

Add Doug Fridsma, M.D., Ph.D., the director of ONC’s Office of Interoperability and Standards, to that list. His Twitter account (@Fridsma) features a picture of himself as a Simpsons character. (Unfortunately, the place to do that, SimpsonizeMe.com, appears to be on hiatus.)

June 15, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Is it even possible to seem unbiased when mentioning politics?

Is it even possible anymore to seem unbiased when reporting on politics or the workings of government? As hard as I try sometimes, there’s always someone who thinks I’m taking a particular side.

The latest example came today in a story I wrote for InformationWeek about the Obama administration’s new White House Rural Council. Created by executive order last week, the council “will focus on actions to better coordinate and streamline federal program efforts in rural America, and to better leverage federal investments,” according to USDA Secretary Tom Vilsack, chair of the council.

That’s obviously the Obama administration’s line. Yet within a couple of hours of the story being posted, someone offered this comment:

Okay, let me see if I got the right? The government is spending more money than ever before, the economy is lagging, and a recession is hanging over our heads and won’t go away. What would the most intelligent man in the world do about this? Spend more money to take better heathcare to rural areas. Wow, were is the logic is this? This whole thing smells fishy, it doesn’t pass the smell test to me.

Thanks for the ‘I love Obama’ speech buddy, but I ain’t buyin’ it. Let’s see how many do come November.

Huh? How is a news story an “I love Obama” speech? All I did was report what the administration said, and included a short, unspecific comment from one of the few interest groups, the National Rural Health Association, that has said anything at all related to the healthcare aspects of this executive order. I don’t see any editorializing there.

Take issue with the administration’s plan all you want, though at least get your facts right. The White House has been pretty vague about the council to this point, but nobody has said anything about spending more money beyond what’s already been allocated for other programs. But don’t call a straightforward, fairly bare-bones news story an “‘I love Obama’ speech.”

I think it’s fair to say that some news organizations are thinly veiled cheering sections for certain political viewpoints. InformationWeek is not one of them. Has our political culture become so poisoned that it’s impossible to come off as objective anymore?

 

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Facebook + health data = all sorts of HIPAA questions

“Time’s Person of the Year is Mark Zuckerberg. Sorry, Julian Assange, I guess you didn’t violate enough people’s privacy.” — Stephen Colbert, Dec. 15, 2010.

Yes, Facebook has issues with privacy. Just Monday, the Electronic Privacy Information Center, the Center for Digital Democracy, Consumer Watchdog and the Privacy Rights Clearinghouse formally asked the Federal Trade Commission to stop Facebook from launching a facial-recognition feature. Last week, European regulators said they would investigate Facebook after it came out that Facebook’s 500 million to 700 million users were automatically opted in to facial recognition.

And now we hear that Microsoft is adding Facebook authentication to its HealthVault health information platform.

Let me repeat: You can now sign in via Facebook to a HealthVault personal health record.

Though I’m not a lawyer, I’m wondering if Microsoft might not be treading in some dangerous territory. What if it’s possible to link HealthVault updates to Facebook so your entire social network knows that you just got a lab test result back? What if the Facebook location tagger indicates that you’ve just visited an STD clinic? Yeah, sometimes discretion is in order, and Facebook generally isn’t the place to be discreet.

According to Healthcare IT News’ MobileHealthWatch blog, Microsoft’s Sean Nolan was practically giddy about this arrangement helping HealthVault go mobile. I think mobility will help make PHRs a bit more attractive to patients, but I still think PHRs are DOA if they don’t link to EHRs.

I just don’t see a lot of medical practices being willing to send electronic data back and forth to HealthVault accounts if Facebook is handling the security, making MobileHealthWatch’s claim that, in wake of the supposed demise or at least de-emphasis of Google Health, HealthVault is now “more or less unchallenged as the PHR of record” a joke. There’s no such thing as a PHR of record, and there won’t be as long as authentication passes through Facebook.

 

June 13, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health Wonk Review gives props to health IT

Finally, health IT gets its due in Health Wonk Review.

Usually an afterthought to this biweekly blog carnival, health IT leads off the latest edition, hosted by Matthew Holt and John Irvine at The Health Care Blog. My post on pushback against IBM’s Watson makes the cut. Check it out.

June 9, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.