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OpenNotes, changing roles in health IT and a Friday, um, funny

I’ve just had two new stories published on the US News & World Report Hospital of Tomorrow site: “OpenNotes Helps Keep Patients Informed and Engaged” and “The Evolution of Health IT Continues.” The latter is subtitled, “New roles signal new realities and priorities as hospital information technology changes,” and goes in depth and the changes underway in hospital HIS and HIM departments in response to various healthcare reform imperatives. I’d appreciate your feedback here, on the U.S. News pages and on Twitter.

Since it’s Friday, I’ll share something offbeat. I’ll let you decide if it’s a good idea or a gimmick. Nestlé Fitness has created the “Tweeting Bra,” with a Bluetooth-enabled sensor that sends a tweet every time the wearer unhooks the undergarment, reminding women daily of the importance of breast self-exams. Here’s a video, in Greek with English subtitles.

 

If you want more information, here’s a short interview with the keeper of the Tweeting Bra, Maria Bakodimus, a Greek celebrity. It’s only in Greek, without subtitles, but it does show the sensors in more detail.

If you want to get one, well, sorry.

 


It was a one-off prototype created for Breast Cancer Awareness Month in October.

February 7, 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.

‘Escape Fire’ leaves out IT, ultimately disappoints

I finally got the opportunity to catch the documentary film “Escape Fire,” a good 15 months after it went into limited theatrical release and became available in digital formats. I thought it would be an eye-opening exposé of all that ills the American healthcare industry, particularly for those who somehow believe we have the greatest care in the world. I excitingly ran this graphic when I first mentioned the movie on this blog back in October 2012:

The well-paced, 99-minute film interviews some notable figures in the fight to improve American healthcare — safety guru and former CMS head Dr. Don Berwick, journalist Shannon Brownlee, integrative medicine advocates Dr. Andrew Weill and Dr. Dean Ornish — as well as some lesser-known people trying to make a difference. It goes through a laundry list of all the culprits in the overpriced, underperforming mess of a healthcare system we have now, and examines approaches that seem to be producing better care for lower cost.

I expected the movie to have a liberal slant, but it really stayed away from the political battles that have poisoned healthcare “reform” the last couple of years. About the only presence of specific politicians were clips of both President Obama and Senate Republican leader Mitch McConnell both praising a highly incentivized employee wellness program at grocery chain Safeway that reportedly kept the company’s health expenses flat from 2005 through 2009, a remarkable achievement in an era of escalating costs.

However, filmmakers Matthew Heineman and Susan Froemke did discuss all the lobbyists’ money presumably buying off enough votes in Washington and at the state level that has helped entrench the status quo. They even scored an interview with Wendell Potter, the former top media spokesman for Cigna, who became a public voice against abuses by health insurers because his conscience got the better of him. As Brownlee noted in the film’s opening, the industry “doesn’t want to stop making money.”

Other reasons given for why healthcare is so expensive, ineffective and, yes, dangerous include:

  • direct-to-consumer drug advertising leading to overmedication;
  • public companies needing to keep profits up;
  • fee-for-service reimbursement;
  • the uninsured using emergency departments as their safety net;
  • lack of preventive care and education about lifestyle changes;
  • a shortage of primary care physicians;
  • cheap junk food that encourages people to eat poorly; and
  • severe suffering among the wounded military ranks.

The filmmakers also kind of imply that there isn’t much in the way of disease management or continuity of care. Brownlee described a “disease care” system that doesn’t want people to die, nor does it want them to get well. It just wants people getting ongoing treatment for the same chronic conditions.

One physician depicted in the movie, Dr. Erin Martin, left a safety-net clinic in The Dalles, Ore., because the work had become “demoralizing.” The same people kept coming back over and over, but few got better because Martin had to rush them out the door without consulting on lifestyle choices, since she was so overscheduled. “I’m not interested in getting my productivity up,” an exasperated Martin said. “I’m interested in helping patients.”

Another patient in rural Ohio had received at least seven stents and had cardiac catheterization more than two dozen times, but never saw any improvement in her symptoms for heart disease or diabetes until she went to the Cleveland Clinic, where physicians are all on salary and the incentives are more aligned than they were in her home town. As Berwick importantly noted, “We create a public expectation that more is better.” In this patient’s case, she was over-catheterized and over-stented to address an acute condition, but not treated for the underlying chronic problems.

The film also examined how the U.S. military turned to acupuncture as an alternative to narcotics because so many wounded soldiers have become hooked on pain pills. One soldier, a self-described “hillbilly” from Louisiana, got off the dozens of meds he had become addicted to and took up yoga, meditation and acupuncture to recover from an explosion in Afghanistan that left him partially paralyzed and with a bad case of post-traumatic stress disorder. The only laugh I had in the movie was when he told the acupuncturist at Walter Reed Army Medical Center in Washington, “Let’s open up some chi.”

I kept waiting and waiting for some evidence of information technology making healthcare better, but I never got it. After leaving the Oregon clinic, Martin took a job at a small practice in Washington state where she was seen toting a laptop between exam rooms, but, for the most part, I saw paper charts, paper medication lists and verbal communication between clinicians.

What really bothered me, however, is the fact that there was no discussion of EHRs, health information exchange or clinical decision support, no mention of the problem of misdiagnosis, no explicit discussion of patient handoffs, continuity of care, medication reconciliation and so many other points where the system breaks down. You can’t truly fix healthcare until you address those areas.

 

January 21, 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.

CNN highlights health apps, clinical intelligence

CNN hasn’t exactly shined of late with its coverage of the Boston Marathon bombing and its aftermath, but the embattled news network got my attention by airing a segment on cutting-edge health IT over the weekend. (Actually, credit goes to Scott Anzel, CEO and co-founder of MDconnectME, one of the three companies featured in the short video.)

MDconnectME makes an app intended to keep people up to date with short, secure messages when their loved ones are in surgery. I actually wrote about Philadelphia-based MDconnectME for MobiHealthNews last fall, after clinicians at Mount Sinai Medical Center in New York found that the app worked well for keeping frazzled family members up to date on patients transferred there when other Manhattan hospitals closed in the wake of Hurricane Sandy.

Also included in this report are Flatiron Health, a clinical intelligence platform for cancer care that’s backed by Google Ventures and LabCorp., and Mango Health, an app supported by Rock Health to encourage medication compliance through a rewards program.

Watch the video here:

You also can see

April 22, 2013 I Written By

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

Guest podcast: Deborah Gordon of Network Health talks reform with Sivad Solutions

Last September, I was a guest on a podcast hosted by Todd Schnick and Charles Davis of Sivad Business Solutions. Afterwards, we decided to share content if and when it made sense. That hasn’t happened until now (actually last month — I’m just getting around to posting now).

Schnick and Davis interviewed Deborah Gordon, chief marketing officer of Network Health, a health insurer in Massachusetts, to discuss healthcare reform. I wouldn’t be posting this if it didn’t have a focus on real reform of health care, and not just insurance expansion, with a strong element of patient safety and attention to outcomes.


From Sivad:

An honor to welcome Deborah Gordon, the Chief Marketing Officer for Network Health. Debbie joins us to talk about one of the more innovative non-profit health plans one can find across the US. You can learn more about Network Health here, the number three health plan for Medicaid health plans.

Discussion topics included:

1. The challenges of serving a very diverse population and customer base, along with lower income customers as a result of income or job situation.

2. Network Health, and states like Massachusetts, have lead the nation in Medicaid health care. How can that trend, and how can the reforms found in Massachusetts, spread across the land?

3. The creation of the Health Insurance Exchange is the key to success…which brings competition and market forces to bear in health care. “It is like Expedia for health insurance…”

4. A focus on quality patient care going forward…

5. What are the challenges going forward, and how does the heated national debate impact the work they are doing.

6. The innovation that’s possible when market forces are at play… “Regulators spawning innovation…”

7. More technology is available and serving the health care markets, which is exciting. But, will access to that technology be accessible to the low income markets?

8. The e-discharge program…

9. The utilization of analytics…

10. Exposing more information to the consumer makes them better patients, healthier, and more compliant to health recommendations…

11. The patient should be the center of the health care system… not the doctor.

12. Debbie was recently named a 2013 USA Eisenhower Fellow, a prestigious fellowship which recognizes emerging leaders who are making momentous contributions to society. In 2013, she will travel to Singapore and Australia where she will explore how these countries have successfully established systems and supports that allow consumers to make good decisions about their health care. The goal is to gather insights and best practices that can be applied here in the U.S.

 

April 16, 2013 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: My interview with Phytel’s Steve Schelhammer from Health 2.0

Last fall, I conducted one of the “3 CEOs” interviews at the 2012 Health 2.0 Conference in San Francisco. For my interview, I drew Steve Schelhammer, CEO of Phytel, a population health management technology provider. Aside from a little technical glitch — one that got edited out of this clip — with Schelhammer’s earpiece microphone not working, I think this went very well. The most amazing part is that this was the first session of the morning and not only was I on time, I was awake and alert.

February 20, 2013 I Written By

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

Attending Health 2.0? Donate your old smartphone

If you’re planning on attending the Health 2.0 conference in San Francisco next Monday and Tuesday, Health eVillages, a program of the RFK Center for Justice and Human Rights, will be collecting used Apple iOS and Android mobile devices. Health eVillages, of which I am a member of the advisory board, will refurbish your device and load it with medical reference materials, clinical decision support tools, drug dosage calculators and other mobile health tools and deploy it to a clinician working in a developing country, helping to bring higher-quality care to that community.

Current Health eVillages sites are in Haiti, China, Kenya, Uganda, with more to come.

If you have a used iPhone, iPod Touch, iPad, Android phone or and tablet (sorry, no BlackBerrys, which is what I happen to have), drop it off at the Health 2.0 registration desk or at the Physicians Interactive booth (No. 37) in the exhibit hall.

If you want to learn more about Health eVillages, founder Donato Trumato, CEO and vice chairman of Physicians Interactive, will be speaking for about 5 minutes on the main stage the morning of Tuesday, Oct. 9, and then will lead a lunchtime presentation at 12:50 p.m. PDT in the Imperial B ballroom at the Hilton San Francisco.

I will be there, too, participating the “3 CEOs” session Tuesday at 8:10 a.m. I will be interviewing Phytel CEO Steve Schelhammer live on stage. Am I nervous? Only about having to get up that early.

 

October 2, 2012 I Written By

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

Rock Health seems to be learning

My first impression of healthcare startup incubator/accelerator Rock Health was not a favorable one. I wrote in MobiHealthNews last July that the San Francisco-based organization founded by some hotshot, young Harvard MBAs demonstrated “yet another example of Silicon Valley arrogance.” I said that Rock Health was mostly targeting the young end of the market with cool, fitness-oriented apps, not the elderly and chronically ill who account for the bulk of the nation’s $2.5 trillion annual healthcare spend. That group wants things that are easy to use rather than fun and hip.

Needless to say, I was not invited to Rock Health’s Christmas party. I did share a quick “hello” nod with Managing Director Halle Tecco when I saw her in a meeting room at the mHealth Summit last month, though.

Even then, I wondered if Rock Health had changed its attitude at all, seeing that even the executives were outfitted in company t-shirts in the buttoned-down world of (just outside) Washington, D.C. (I once had a Capitol Hill press pass early in my career. The rules require members of the media to conform to the same dress code as members of Congress. That means a coat and tie for men, while women have to have jackets if they choose to wear slacks. An unwritten rule of D.C. in general calls for women to wear stockings if they go with a skirt, even if it’s 95 degrees and humid, which it frequently is in the summer.)

Today, though, I saw a clear sign that Rock Health is starting to learn from its earlier mistakes. MobiHealthNews reported on the incubator’s class of 2012, and I was pleasantly surprised to see that the majority of the 15 companies are aimed at either healthcare providers—an important constituency largely missing from the first Rock Health class—and on treatment of truly sick patients. One startup, for example, helps people being treated for breast cancer prepare for doctor visits, while another produces an EHR for home-health agencies. Good stuff in my critical eyes, though really, enough with the social networking to get people to exercise. There are too many of these platforms and apps already.

I never thought I would say this, at least not before the end of 2011, but kudos to Rock Health for making a real effort to figure out the complex healthcare industry and to add some substance to what heretofore had been all style.

December 20, 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.