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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.

Videocast with ATA: Mobile health predictions for 2014

A couple of weeks ago while I was in Washington for the U.S. News & World Report Hospital of Tomorrow conference, I stopped by the headquarters of the American Telemedicine Association to record a videocast with ATA CEO Jonathan Linkous. We discussed some of my predictions for 2014 in the fields of mobile health and telehealth:

  1. Imperative to cut costs will drive demand.
  2. More mental health services will be delivered remotely.
  3. Clarity from the FDA means more diagnostic apps and smartphone add-on devices.
  4. Patient engagement in Stage 2 Meaningful Use might finally make untethered PHRs and consumer-facing apps viable.
  5. Home monitoring and video chats will help prevent hospital readmissions.
  6. State licensing issues persist but some states are looking to adapt their rules to facilitate telemedicine.

I’m going to try to embed the video here. If not, here’s the ATA’s link.

 

November 15, 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 Hands On Telehealth

I recently was a guest on a vodcast with Nirav Desai, founder and CEO of telehealth consulting firm Hands On Telehealth, whom I met because I moderated a panel he was on at the American Telemedicine Association‘s annual conference in May. In a Skype interview that went up late Friday, we chatted for 45 minutes about telehealth, the broader  health IT landscape and how it all fits into U.S. healthcare reform.

I’m unable to embed the video on this page, so please visit the Hands On Telehealth page to watch the interview. (That’s a screen grab below.) The page contains a detailed description of the interview, much as I like to have for my own podcasts. Perhaps next time I’ll spend more time looking directly at the camera. :)

Hands On Telehealth screen grab

July 1, 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.

Health Wonk Review: money talks, but IT helps

The latest edition of Health Wonk Review is hot off the digital presses, with Joe Paduda taking hosting duties on his Managed Care Matters blog. And managed care does matter in this trip around the health blogosphere, with most of the attention on healthcare costs and insurance coverage.

On the quality front, which is my primary interest these days, there is some interesting discussion about  whether the new Medicare hospital readmissions policy truly will produce better care or will prod some into providing the minimum level of service to readmitted patients.

(Frankly, hospitals have been overtreating for years. If a minimal level of service gets the job done for the patient, that’s a good thing. And the policy is supposed to cause hospitals to do the right thing in the first place, knowing that they will lose out later if they don’t. I’m all for that.)

My post on consumer ignorance of telemedicine is in there, as is a good one from Vince Kuraitis and Leslie Kelly Hall about the duty providers have to share information with patients. EHRs and wearable sensors also make this edition of HWR. Not bad from an IT perspective.

May 10, 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.

So many types of telehealth

Here’s a short video (720p HD) I put together from the just-concluded American Telemedicine Association’s annual conference in Austin, Texas. No wonder it’s so hard to get a real sense of the size of the telehealth and telemedicine market when there are so many components and so many different definitions. This is a row of banners outside the meeting rooms highlighting the various types, not to mention some of the ATA’s constituencies and important topics at the conference. I did the voice-over at 1:30 in the morning.

May 8, 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.

Patients with complex cases don’t want multiple provider portals, Rady CIO says

How about some real, original content for a change? Yeah, that’s why you started coming to my blog in the first place, isn’t it? You’re tired of nothing but video embeds from others and short, offbeat attempts at humor.

I recently interviewed Albert Oriol, CIO of Rady Children’s Hospital-San Diego, for a story that will appear elsewhere (read: a paying client) soon, but I had a lot of material I left out of that story. I get to use some of the rest here in a little experiment to see what it does to this site’s traffic.

Obviously, pediatric hospitals aren’t eligible for the Medicare side of meaningful use, which is why the threshold is lower for qualifying for Medicaid bonuses. Pediatricians and children’s hospitals only need to have 20 percent of their visits with Medicaid patients, compared to 3o percent for other providers. Rady meets that standard and already has attested to Stage 1.

Oriol, however, does not like the way the rules are written, calling some of them “well-intentioned mandates with unintended consequences.” For example, providers must offer portals for some of their patients – 10% in Stage 1, rising to 50% in Stage 2. But patients with complex conditions go to multiple providers, each of which may have unique portals. “It’s inconvenient for them to go to many different portals,” he says.

He also is frustrated with having to build reports knowing that many of the items will not apply to pediatric subspecialties. “It’s not the best use of resources,” Oriol says.

The two things at the top of mind for Oriol these days are telemedicine and advanced analytics. Rady is expanding its telemedicine program to support rural areas in Imperial County, a poor, isolated jurisdiction east of San Diego County along the Mexican border. He believes this will provide value and convenience to primary care physicians and patients alike.

On the analytics front, Rady is working on a demonstration project with California Children’s Services (CCS), a managed care program for children in the state’s MediCal system with certain diseases. “We’re going to bring in data from other providers,” Oriol says.

The hospital also is “taking a big step forward” in innovation and discovery by partnering with industry to research technology and the analytics of technology, according to Oriol.

 

April 28, 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.

Chart: Current state telemedicine legislation

Here’s a handy chart from the American Telemedicine Association showing the current status of telemedicine legislation in all 50 states plus D.C. Specifically, it shows which states have already mandated private and Medicaid insurance coverage for telemedicine services, as well as which states are considering such a law. (Medicare policy of course is set at the federal level.) This information is current as of this month.

 

State telemedicine legislation

February 21, 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.

Telemedicine from the 1920s?

I saw an interesting article today on Smithsonian magazine’s Paleofuture blog, suggesting that an early radio and publishing professional may have predicted telemedicine as early as 1925.

According to the article, that person, Hugo Gernsback, predicted that within 50 years, by 1975, there would be a contraption he called the “teledactyl.” With this device, physicians would be able to see patients on a television screen (TV did exist in 1925, though it hadn’t reached the masses) and also “touch” patients with radio-controlled arms.

Gernsback wrote:

The busy doctor, fifty years hence, will not be able to visit his patients as he does now. It takes too much time, and he can only, at best, see a limited number today. Whereas the services of a really big doctor are so important that he should never have to leave his office; on the other hand, his patients cannot always come to him. This is where the teledactyl and diagnosis by radio comes in.

Here’s how Gernsback visualized it, on the cover of the February 1925 issue of Science and Invention magazine, which he published.

Incidentally, according to the Smithsonian article, Gernsback just a year later launched a new magazine called Amazing Stories, supposedly the first publication fully dedicated to science fiction. Clearly, though, there was more than a little truth in the 1925 forecast.

March 27, 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.

Bet on videoconferencing growth before PHR ubiquity

Last week, I reported in InformationWeek on a Manhattan Research study showing that 7 percent of U.S. physicians were chatting with patients via videoconference. What the research didn’t say is how many consultations actually take place by videoconferencing. My guess is that it’s minuscule, but virtual visits will soon become commonplace.

According to Australian online healthcare community eHealthSpace, technology vendor Siemens is forecasting that 20 percent of all medical consultations in Australia will take place online by 2020. Much of that growth will come from rural and remote areas of a vast country that’s full of remote, sparsely populated areas.

I find that much more believable than another Siemens prediction that 90 percent of Aussies will have a “personally controlled electronic healthcare record” (whatever that means) by 2020. I’m guessing that videoconferencing with doctors will boom long before there’s widespread adoption of any health record controlled by patients.

 

June 3, 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.

Skype for ‘redneck telehealth’?

Kudos to Barbara Duck of The Medical Quack blog for coining a new term: “redneck telehealth.”

A friend of hers had an outbreak of gout while getting ready to board an overseas flight. “He had called his doctor who was not set up with any of the new telehealth programs and software that is just now becoming available so I said ‘get your doctor on Skype and put your foot up there for him to see,’” Duck explained in a post over the weekend. “Obviously this is not a perfect situation for either side for a real diagnosis, but as the old saying goes a picture is worth a 1000 words and that’s what this would do.”

Actually, I’ve heard that because a picture is worth 1,000 words, a video is worth 1 million words. Since laptops tend to have built-in webcams these days and a lot of 3G smartphones can transmit live, mobile video (hey, even some 2.5G phones can do so over a Wi-Fi connection, like you might find in say, an airport), why not fire up Skype or FaceTime or similar videoconferencing program and show your foot to your doctor? If you don’t like the term “redneck,” just call it a video call or an ad-hoc network.

Or are we expecting far too much by assuming that the doctor would one, be available on short notice, and two, voluntarily share his/her mobile number or Skype screen name with a patient?

May 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.