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More health IT comedy means the public is taking notice

I often share jokes and humorous videos here, sometimes because a product is worthy of ridicule, but also to illustrate how some health IT is going mainstream. I’m going to do it again today because two things happened in the last week that I had not seen before.

First, though Stephen Colbert has made fun of digital health and fitness products before, last week he took it upon himself to do so on consecutive nights.

On Sept. 8, he took down the forthcoming Pavlok fitness bracelet, a product that sends an electrical jolt to the wearer’s arm as a reminder to exercise. It also debits the user’s bank account and posts an embarrassing message on Facebook. No, really. “When you’re in a dark place, alone at home, out of shape and too tired, overweight or depressed to work out, it’s probably because you weren’t getting enough public humiliation,” Colbert said.

 

A night later, Colbert, like the rest of the world, was talking about the Apple Watch. After cheering wildly about the announcement, Colbert asked, “What does it do?” He then showed a picture of himself from high school and said it was finally cool to wear a calculator watch.

 

Then, on Friday, no less than America’s Finest News Source, The Onion, got into the act with its “American Voices” feature, in which common people (actually, the same five or six headshots recycled for years with different names and occupations) give their fake opinions on a newsworthy topic. That day, the subject was, “Patients Making Record Number Of Telehealth ‘E-Visits’ With Doctors,” with a reference to an actual Deloitte study on that very topic.

As one “commenter” said, “Until doctors can email me painkillers, I don’t see the point.”

 

September 16, 2014 I Written By

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

Podcast: Greenway Health CEO Tee Green on interoperability, consumerism and more

Health IT vendor Greenway Health recently finished its rollout of a cloud-based EHR to all 8,200 Walgreens stores in the U.S. When I was offered the chance to interview CEO Wyche T. “Tee” Green III about this, I decided to take it a step further.

In all my years of covering health IT, I’ve never met nor even spoken to Green, so I figured a podcast was in order. After all, I had written a piece for Health Data Management earlier this year about how pharmacies are reshaping themselves as true healthcare companies. (This interview also comes in the wake of CVS Caremark ending its sale of tobacco products and changing its name to CVS Health.)

I also had a lot of questions about interoperability issues in health IT and the many criticisms that lately have been heaped on both EHR vendors for perceived usability problems and the federal Meaningful Use EHR incentive program. The timing couldn’t have been better.

Podcast details: Interview with Greenway Health CEO Tee Green, recorded Sept. 8, 2014. MP3, mono, 128 kbps, 25.5 MB. Running time 27:51

1:00 Walgreens rollout and EHRs for “retail health”
3:20 Future expansion to Walgreens Healthcare Clinic locations
4:15 My own experience with lack of interoperability at a CVS MinuteClinic
5:30 Achieving EHR interoperability
7:30 Frustration with slow progress on Meaningful Use
10:30 Data liquidity
12:30 Update on CommonWell Health Alliance
14:25 Addressing criticisms that vendors are hindering interoperability
16:30 EHR usability
18:10 Greenway Marketplace app store
22:15 Patient engagement and slow start to Stage 2 Meaningful Use
24:10 Dealing with the rise of consumerism in healthcare

I’ve been kicking around in my mind the idea of hosting a regular podcast, perhaps as frequently as weekly. If so, what day of the week would you prefer to hear a new episode?

September 12, 2014 I Written By

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

Video: StartUp Health co-founder talks Health Datapalooza on CNBC

Unity Stoakes, co-founder and president of entrepreneurship academy StartUp Health, was in Washington this week for Health Datapalooza. Tuesday morning, with the Capitol dome serving as a picturesque background, he appeared on CNBC’s “Squawk Box” to talk innovation in digital health. Stoakes used more than a couple of buzzwords, such as “revolution” (see my commentary for Forbes on Apple’s just-announced HealthKit mocking the notion of a revolution) and “creative destruction,” and CNBC added a few more, like “disruptive” and “tectonic shift”

But he did temper the enthusiasm with a reality check. “To be quite honest, there’s a lot of uncertainty,” Stoakes said when asked about who the losers would be in the new healthcare world. Have a look, and share with your friends outside of healthcare so they get a bit of a sense about what digital health is and where true healthcare reform might come from.

Visit NBCNews.com for breaking news, world news, and news about the economy

In case you missed it, I interviewed Stoakes last month for a story in Healthcare IT News about breaking down data silos in digital, mobile and “connected” health.

June 5, 2014 I Written By

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

Podcast: Owen Tripp, CEO of Grand Rounds

Yesterday, Grand Rounds, a San Francisco-based startup that makes an “outcomes management platform” for large employer groups, introduced Office Visits, an online service that helps consumers find “quality” physicians close to home. I’ve long been skeptical of any claims of healthcare quality or any listing of “best” physicians or hospitals, so I invited Grand Rounds co-founder and CEO Owen Tripp on for a podcast to explain what his company is doing.

He told me that a proprietary algorithm helps Grand Rounds “recommend with confidence” the top physicians among the 520,000 medical specialists the company graded nationwide, based on numerous publicly available data sources and some self-reporting. Of those more than half a million specialists, only about 30,000 meet the company’s criteria for recommendation, which shows, at the very least, that Grand Rounds is highly selective.

Based on this interview, I think the product has a lot of potential. It’s nice to see ratings based on outcomes data and not squishy criteria like “he is a great doctor,” as parodied in The Onion this week (“Physician Shoots Off A Few Adderall Prescriptions To Improve Yelp Rating”).

At about 18:30, the conversation reminds me of another recent podcast, with University of Rochester neurologist Dr. Ray Dorsey. It turns out that Dorsey is among the 1,000 or so medical advisors to Grand Rounds.

Podcast details: Interview with Owen Tripp, co-founder and CEO of Grand Rounds. MP3, stereo, 128 kbps, 23.8 MB, running time 26:04.

1:00 “Safety” vs. good outcomes
2:20 “Downright terrifying” facts about choosing doctors
4:15 Story behind Grand Rounds
5:30 Algorithm for measuring physician quality that he says has shown about a 40 percent lower rate of mortality on common cardiac procedures
7:10 Data sources, including some self-reporting
8:35 Care coordination services Grand Rounds provides for patients
9:50 Why the direct-to-consumer market is so difficult in healthcare
12:00 Care teams
14:00 Availability and scope of service
16:15 When patients should travel for care and when they should not
18:15 Elements of telemedicine
19:35 Importance of asynchronous communication
21:45 Target market and why he sees the $200 fee as a bargain for patients
23:35 Managing patient records and other data
24:35 Company goals

April 9, 2014 I Written By

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

Digital health at the Mid-America Healthcare Venture Forum

In case you haven’t seen the official announcements or caught my tweets, later this month I will be moderating a panel at the Mid-America Healthcare Venture Forum, an event being put on by MedCity News, April 22-23 at the J.W. Marriott hotel in Chicago.

The panel is called “Opportunities (and Challenges) in Digital Health. Per the official description: “Digital health — and its business models — are coming of age. Promising young companies are integrating into healthcare and, in some cases, beginning to find exit partners. But that’s also meant new scrutiny from everyone from investors to the FDA. Learn about the challenges, opportunities and promising new markets in digital health.”

Panelists include: Amy Len, director of Chicago-based accelerator Healthbox; Julie Kling, director of mobile health at Verizon Wireless; and Jack Young, who heads the Qualcomm Life Fund for Qualcomm Ventures. I’ll just be there to keep order, and, of course, to cast my usual, skeptical eye on the field and continue to wonder why investors are throwing so much money at me-too fitness trackers and countless direct-to-consumer products that don’t stand a chance in an industry where nearly everything is paid for by third parties. Or at least that’s my thought at the moment, until we have our conference call next week. :)

The session is scheduled for Wednesday, April 23, at 8:55 a.m. CDT. The hotel is located at 151 W. Adams St. in the heart of the Financial District. Years ago, I worked about two blocks west of there, so I know it’s about 40-45 minutes away from me by public transit, and I’m not a morning person. This could get  interesting. (If any MedCity people are reading this, I’m kidding. I’ll be there on time. Hopefully.)

Our session follows a keynote from James Rogers, chairman of Mayo Clinic Ventures. After the panel is a break, then breakout sessions featuring presentations to investors from startups in digital health, medical devices and pharma/biotech. I hope I don’t prematurely burst anyone’s bubble with too much of a reality check. But, in honor of this week being the 25th anniversary of the release of the great Gen X satire, “Heathers,” I offer this quote from the movie: “Heather told me she teaches people ‘real life.’ She said, real life sucks losers dry.”

Wait, was that too cynical?Let me just say that the panel just got another thing to talk about today, as the FDA, FCC and ONC just released their proposed health IT regulatory strategy, as called for by the Food and Drug Administration Safety and Innovation Act (FDASIA). To nobody’s surprise, they recommend a “risk-based framework” to regulation of health IT and digital health. Now to figure out if there are any details people should be concerned about…

In the meantime, you can register for the conference here.

April 3, 2014 I Written By

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

eHealth Initiative ‘2020 Roadmap’ panel needs consumers

This press release showed up my inbox on Tuesday:

eHealth Initiative Launches 2020 Roadmap Process

Framework to Change the Future of Nation’s Healthcare System

March 25, 2014, Washington, D.C. – The eHealth Initiative (eHI) announced the launch of the eHealth Initiative 2020 Roadmap, a public-private collaboration that will help guide the  transformation of the nation’s healthcare system by 2020. With the help and support of a  wide array of leading healthcare associations, organizations, and federal agencies, 2020 Roadmap will propose key policy recommendations to implement at a federal level and actions for the private sector to help transform healthcare.

“Health reform calls for transformation to a value-based interoperable system, but there is no direction on how to transition from our current work processes and systems. Clinicians, payers and providers are in dire need of leadership to help transform delivery systems and control cost,” said Jennifer Covich Bordenick, Chief Executive Officer of the eHealth Initiative. “The goal of our new initiative is to craft a multi-stakeholder solution that coordinates the efforts of both the public and private sector so that we can make this transition successfully.”

The 2020 Roadmap will be developed over the next six months through a series of surveys, webinars, executive roundtables, and events with key constituencies; the outcome will be a consensus on how to shape the future of our healthcare system.  Individuals are welcome to complete surveys, participate in upcoming events, and provide general feedback. A new survey is currently being fielded to gather information from the industry.

The 2020 Roadmap will focus on recommendations that:

•        Identify a sustainable glide path for meaningful use;

•        Promote interoperable systems;

•        Transform care delivery; and

•        Balance innovation and privacy.

Several advisors representing different stakeholders are leading the 2020 Roadmap activities, including:

·         John Glaser, PhD, Chief Executive Officer, Health Services, Siemens (representing vendors)

·         Sam Ho, MD, Executive Vice President and Chief Medical Officer, UnitedHealthcare, Chair eHI Board of Directors, (representing payers)

·         Christopher Ross, MD, Chief Information Officer, Mayo Clinic (representing providers)

·         Susan Turney, MD, Chief Executive Officer, Medical Group Management Association (representing clinicians)

·         Micky Tripathi, PhD, President and Chief Executive Officer, Massachusetts eHealth Collaborative (representing information exchanges)

·         Joseph Touey, Senior Vice President, North American Pharmaceuticals, Information Technology, GlaxoSmithKline (representing pharmaceutical manufacturers)

“The impressive caliber of individuals leading our effort reflects the importance of the 2020 Roadmap,” said Jennifer Covich Bordenick. “We invite all organizations to participate in this important process and bring the best thinking to the table.”

Visit the 2020 Roadmap webpage for more information at http://www.ehidc.org/2020-roadmapMore information about the eHealth Initiative is available online at www.ehidc.org.

###

About the eHealth Initiative: The eHealth Initiative (eHI) is a Washington D.C.-based, independent, non-profit organization whose mission is to drive improvements in the quality, safety, and efficiency of healthcare through information and information technology. eHI is the only national organization that represents all of the stakeholders in the healthcare industry. Working with its membership, eHI advocates for the use of health IT that is practical, sustainable and addresses stakeholder needs, particularly those of patients. www.ehidc.org .

What immediately jumped out at me was the list of advisors. I’m familiar with most of the names, and I am sure all are qualified to provide valuable input on how to promote interoperability and improve our nation’s broken healthcare infrastructure. But the notes on representation raise an important question: How come nobody is representing consumers?

It’s after hours as I read the press release and I post this commentary, but I’ve e-mailed the press contact to see if the eHealth Initiative has a good answer. I will report back as soon as I hear anything. In the meantime, consumer and patient advocacy groups should take Bordenick up on her offer to participate.

UPDATE, March 27, 11 am CDT: I’ve just received this response directly from Bordenick:

Please know that the news release just highlighted just a few of the individuals and groups that will be involved.  We absolutely welcome the representation and involvement of patient and advocacy groups, and any stakeholder groups who want to participate— that is one of the reasons we put the announcement out, and asked people to fill in contact info in the survey. We are at the very start of this process, so now is definitely the time to get engaged. We currently work with National Partnership for Women and Families, Center Democracy & Technology, American Cancer Society, and have just started work with Smart Patients, and many others. We expect all of these groups to continue working with us, and many others to join in the process.

So there you have it. As I said in the original post, consumers and patient advocacy groups should take Bordenick up on the offer. It sounds like she would appreciate it.

March 26, 2014 I Written By

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

Another PHR venture (yawn) brings in some big names

I normally shy away from stories about the crowded and, to this point, spectacularly unsuccessful field of untethered personal health records, but one got my attention this week because of the names it’s just attracted.

Box, a cloud-storage company that offers something similar to Dropbox or Google Drive, has hired former White House CTO Aneesh Chopra and former Allscripts CEO Glen Tullman to, according to VentureBeat, “help the company push into the notoriously tricky health care vertical.” That’s an understatement. (Full disclosure: I serve on the advisory board of Health eVillages with Tullman, but I’m not in regular contact.)

Those hires bring instant credibility, though not necessarily success, and shows, as I’ve said before, that untethered PHRs might stand a chance once providers start addressing the patient-engagement requirements of Meaningful Use Stage 2. Emphasis on “might.” To date, nobody has found a way to get more than a small handful of patients to control their own medical data via PHRs.

Chopra — who once was managing director of the Advisory Board Co. and led open-data  efforts as secretary of technology in Virginia prior to joining the Obama administration — and Tullman know the health IT business better than most, but I still cast a skeptical eye on any PHR company until they prove to me they can capture a market. None ever has.

Good luck, gentlemen. You will need it.

 

March 19, 2014 I Written By

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

Video: Farzad Mostashari on patient engagement, ‘physician ACOs’

As I alluded to earlier, I was leaving the press room one afternoon at HIMSS14, and there I see former national health IT coordinator Dr. Farzad Mostashari hanging around Gregg Masters and Dr. Pat Salber of Health Innovation Media. It turns out, Masters and Salber had just pulled Mostashari aside to do an interview on video, but they didn’t have anyone to interview him on camera, so they asked me right there on the spot to be the interviewer. Here is the result.

Mostashari, now a visiting fellow at the Engelberg Center for Health Care Reform at the Brookings Institute in Washington, discussed how the years of searching for a business model to coordinate care and engage patients is finally starting to pay off. Always the champion of the little guy in healthcare, Mostashari also brought up the notion of physician-led ACOs, or, as he called it, the “Davids going up against the Goliaths.”

 

I had pretty much no preparation for this interview. It probably shows. I still think it worked out well.

Here’s a link to Salber’s post about the interview because I don’t want to steal page views. :)

March 14, 2014 I Written By

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

HIMSS, Continua launch Personal Connected Health Alliance

ORLANDO, Fla.—As HIMSS President and CEO hinted at yesterday in his podcast with me, HIMSS today announced the formation of the Personal Connected Health Alliance, in conjunction with the Continua Health Alliance and the HIMSS-owned mHealth Summit.

This short video from HIMSS explains:

Also, Lieber mentioned that HIMSS has not signed on to a letter from 48 organizations—led by CHIME—to HHS Secretary Kathleen Sebelius, calling for more time and flexibility in meeting Meaningful Use Stage 2 requirements., Lieber said HIMSS declined to sign because the requests were, in his opinion, “very vague.”

Today, the letter, dated Feb. 21, was made public:

February 21, 2014
The Honorable Kathleen Sebelius
Secretary
Department of Health and Human Services
200 Independence Ave., S.W.
Washington, DC 20201

Dear Secretary Sebelius:

The undersigned organizations write to express immediate concerns confronting our respective members’ ability to comply with the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program. We recognize the vital role your department has taken in advancing the adoption of health information technology in the United States and appreciate your willingness to be flexible in extending the start of Stage 3 to 2017. We fear the success of the program is in jeopardy, however, if steps are not taken now to address our shared concerns.

Over the next seven months, more than 5,000 hospitals and 550,000 eligible professionals must adopt the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) and meet a higher threshold of Meaningful Use criteria. Failure to do so will not only result in a loss of incentive payments, but also the imposition of significant penalties. With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers. This inhibits the ability of providers to manage the transition to the 2014 Edition CEHRT and Stage 2 in a safe and orderly manner.

We are concerned this dynamic will cause providers to either abandon the possibility of meeting Meaningful Use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case. The first choice limits the success of the program to achieve widespread adoption of EHR, while the second is highly disruptive to healthcare operations and could jeopardize patient safety. As you know, our members’ number one priority must be to provide safe and high quality care to patients.

Providers need adequate time to learn how to use the newly deployed technology, including examining staff assignments, workflows, and practice processes. If providers move forward, as dictated by the current policy, our concerns regarding rushed implementations are heightened. Furthermore, we believe the “all or nothing” approach – where missing a single objective by even a small amount results in failure for the program year – compounds our concerns.

For these reasons, our organizations strongly recommend that HHS:
1. Extend the timelines providers have to implement 2014 Edition Certified EHR software and meet the Program requirements (Stages 1 and 2) through 2015;
2. Add flexibility in Meaningful Use requirements to permit as many providers as possible to achieve success in the program.

Given that we are well into 2014, immediate attention to these concerns is warranted. This additional time and new flexibility are vitally important to ensure that hospitals and physicians continue moving forward with technology to improve patient care. By making such changes, HHS would be demonstrating needed flexibility to maximize program success, without compromising momentum towards interoperability and care coordination supported by health IT.

We remain committed to the success of the program and look forward to hearing from you on this important matter. Please contact Jeffery Smith, Senior Director of Federal Affairs, CHIME, (jsmith@cio-chime.org) should you have any questions. Thank you for your consideration.

Sincerely,

AMDA-Dedicated to Long Term Care Medicine
American Academy of Allergy, Asthma & Immunology
American Academy of Dermatology Association
American Academy of Family Physicians
American Academy of Home Care Medicine
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Orthopaedic Surgeons
American Academy of Otolaryngology—Head and Neck Surgery
American Association of Neurological Surgeons / Congress of Neurological Surgeons
American College of Cardiology
American College of Osteopathic Family Physicians
American College of Osteopathic Internists
American College of Osteopathic Surgeons
American College of Physicians
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Health Information Management Association
American Hospital Association
American Medical Association
American Osteopathic Academy of Orthopedics
American Osteopathic Association
American Psychiatric Association
American Society for Clinical Pathology
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society of Anesthesiologists
American Society of Cataract and Refractive Surgery
American Society of Hematology
American Urological Association
America’s Essential Hospitals
Association of American Medical Colleges
Catholic Health Association of the United States
Children’s Hospital Association
College of Healthcare Information Management Executives
Federation of American Hospitals
Heart Rhythm Society
Infectious Diseases Society of America
Medical Group Management Association
National Rural Health Association
North American Spine Society
Premier healthcare alliance
Society for Cardiovascular Angiography and Interventions
Society of Thoracic Surgeons
The Endocrine Society
VHA Inc.

Yes, that is kind of vague, but that’s what you get when you involve four dozen organizations. Will it be effective? As I mentioned yesterday, ONC Chief Medical Officer Jacob Reider, M.D., hinted that there will be news about Stage 2 flexibility, likely Thursday morning at a joint ONC-CMS town hall. Reider made that statement at the CIO Forum, hosted by CHIME.

 

 

February 24, 2014 I Written By

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

Podcast: HIMSS CEO Steve Lieber, 2014 edition

It’s time for my annual podcast interview with HIMSS President and CEO Steve Lieber, this time from the Orange County Convention Center in Orlando, Fla., on the day before the official opening of the 2014 HIMSS Conference, rather than in his Chicago office a week or so in advance.

Lieber reiterated HIMSS’ position that the federal government should extend the attestation period for Meaningful Use Stage 2 by one year. I wasn’t there, but today at the CIO Forum, one of the preconference educational symposia, ONC Chief Medical Officer Jacob Reider, M.D., hinted that there will be an announcement on Stage 2 flexibility, possibly Thursday morning at a joint ONC-CMS town hall. That session will feature CMS Administrator Marilyn Tavenner and new national health IT coordinator Karen DeSalvo, M.D. I’ve never heard either of them speak, and now I’m excited to be covering that session.

We also discussed other aspects of healthcare reform, trends in health IT and expectations for HIMSS14. Of note, on Monday morning, HIMSS and two other organizations will announce a new initiative on “personal connected health.”

Near the end, I reference the podcast I did last week with Dr. Ray Dorsey about remote care for Parkinson’s patients. For easy reference, here’s the link.

This is, I believe, the seventh consecutive year I have done a podcast with Lieber at or just before the annual HIMSS conference. Another interview that has become somewhat of a tradition won’t happen this time, as Athenahealth CEO Jonathan Bush is not making the trip to Orlando this year.

 

Podcast details: Interview with HIMSS President and CEO Steve Lieber, Feb. 23, 2014, at HIMSS14 in Orlando, Fla. MP3, stereo, 128 kbps, 36.2 MB. Running time 39:35.

0:40 “It’s time to execute.”
1:40 Challenges for small hospitals and small practices
3:10 New ONC EHR certification proposal and continued questions about Meaningful Use Stage 2
5:00 Prioritizing with multiple healthcare reform initiatives underway, including proposed SGR repeal
6:30 Surviving ICD-10 transition
7:35 HIMSS’ position on MU2 timelines
9:05 Remember “macro objective” of Meaningful Use
10:00 Letter to HHS from organizations not including HIMSS calling for what he says are “very vague” changes to MU2 criteria
11:40 Things in MU2 causing providers fits
13:05 Fewer EHR vendors certified for 2014, but more HIMSS exhibitors
15:00 What this means for providers who bought products certified to 2011 standards
17:20 Progress on Meaningful Use so far
21:00 Looking toward Stage 3
22:42 What healthcare.gov struggles might mean for health IT
25:35 Other aspects of the Affordable Care Act being lost in the public debate
27:10 Political considerations related to health IT
29:40 Patient engagement and new HIMSS exhibitors
32:20 Why healthcare spending and provider shortage forecasts don’t account for efficiency gains made from technology and innovation
35:10 Demographic challenges for healthcare
35:45 Shift from hospitals to ambulatory and home care and consolidation of provider organizations

February 23, 2014 I Written By

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