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Showing posts from June, 2009

EMRs and "Meaningful Use."

Health care providers showing "meaningful EMR use" by 2011 are eligible for incentive payments from the $20 billion EMR stimulus package. Writing in netdoc.com, Patricia King, JD outlines the details for physicians:
"To be a "meaningful EHR user", the physician must satisfy three criteria:

* The physician must use "certified EHR technology" in a meaningful manner, including electronic prescribing.
* The physician must demonstrate that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination.
* The physician must submit information on clinical quality measures specified by HHS.

HHS will designate the way in which a physician is recognized as a meaningful user (through attestation, submission of claims with codes indicating that a patient encounter was documented using certified EHR technology, survey responses, submission…

It's The Idaho/Wharton/Phoenix/Colorado/Mayo Innovation Mashup

From IdahoStatesman.com: Officials launched THE CORE, an enterprise zone for health care, education and technology enterprises. St. Luke's Meridian Medical Center is on board along with dozens of other public and private enterprises. The trend continues of health care providers playing leading roles in their community's economic development.

From Knowledge@Wharton, sometimes innovation takes a village. It's a thought-provoking article on the benefits of opening up innovation processes to thought leaders and partners outside your organization's walls. What if you created an extranet and posted your innovation priorities for all to see? Let's say you wanted to improve a discharge planning process. How many more good ideas would you get if you asked thousands of people instead of just a few?

From Medical News Today, a Health Leaders-Interstudy report trends in the Phoenix market of EMR "de-installation" or contract cancellation due to training, functiona…

"UAB Health System Announces Inaugural Innovation Award Winners."

While many health systems find it difficult to expand their focus much beyond day-to-day survival, a few recognize the power of teams with innovative ideas to drive measurable, long-term improvements in key strategic indicators. Example: the UAB Health System...
"The UAB Health System has announced the winners of its inaugural Innovation Awards, which acknowledge novel and inventive programs, policies, ideas and processes implemented in the last two years that have led to significant, measurable improvements in patient care and/or operational efficiency.

"The awards recognize best practices in UAB Health System entities and affiliates, with a goal of promoting widespread adoption of exceptional programs and ideas. Montgomery-based Baptist Health took first place in this first year of the program after the Health System CEO Council reviewed 36 nominations and selected three winners in each of two categories: Impact, for programs that have had the greatest positive effects on …

There's More To A Name Than Just A Name

It's no accident that the best-branded health care organizations are those with physicians tightly integrated into the cultural and decision-making fabric. Mayo, Cleveland Clinic, Kaiser, Geisinger, Virginia Mason, to name a few, have a decided advantage over the more traditional private practice model where physicians are, at best, an arms length away and, at worst, strong competitors.

I remember making a site visit to one of the above-named organizations, and hearing the CEO (a physician) say very clearly "Our customer is the patient. Period. Anybody not agreeing doesn't work here!" Wow, now THERE'S the platform for an enduring competitive advantage.

Everything in that organization - the people, the processes, the planning, the facility, the scheduling, everything - is all directed toward acting on that "patient as customer" premise. I'm sure there's internal debate about a great many things, maybe even an argument or two, but the basic, cl…

"New iPhone Application Offers Instant Access to Health Cost Information."

From AIS's Health Business Daily, here's Managing Editor Michael E. Carbine discussing a creative new iPhone application for consumer-directed health plan enrollees.

"Canopy Financial's Mobile Consumer Directed Healthcare (CDH) Software Application, the only such one, allows iPhone and iPod Touch users to search medical procedures using keywords to determine if they are eligible for payment using their spending accounts, a valuable capability in its own right. But when the user identifies a specific procedure, the application not only maps the location of local providers offering the procedure but also pulls up the customary cost of the procedure based on the consumer's ZIP code.

...

"The medical expense locator feature combines Canopy data on procedure rates with the iPhone's integrated mapping application to match procedures with providers in the user's ZIP code. Contact information for all identified providers also is displayed. A Procedure Cost Anal…

From Seth Godin: "This Industry Deserves To Die."

Of course he's talking about the textbook-publishing industry, and as the father of 4 daughters, college age and older, I wish the death would've occurred, oh, about 8 years ago.

Why is death deserved? Let's see...too expensive, resistant to change, uninspiring, impractical. Says Godin,
"The solution seems simple to me. Professors should be spending their time devising pages or chapterettes or even entire chapters on topics that matter to them, then publishing them for free online. (it's part of their job, remember?) When you have a class to teach, assemble 100 of the best pieces, put them in a pdf or on a kindle or a website (or even in a looseleaf notebook) and there, you're done. You just saved your intro marketing class about $15,000. Every semester. Any professor of intro marketing who is assigning a basic old-school textbook is guilty of theft or laziness."I hope some health care leaders are paying attention. As adjectives, "expensive, resist…

Putting Patients In Charge Of Health Care, From the NY Times

A former boss once referred to health care providers' endless, inward-focused bureaucratic narcissism as "navel-gazing." Jack Welch framed it slightly more elegantly when he said something along the lines of "It's not that bureaucracies dislike customers. They don't. They just don't find them as interesting as they do themselves."

Now, Dr. Pauline Chen, writing in the New York Times, discusses Dr. Donald Berwick's philosophy of "patient centeredness" and its provocative implications that health care would work better if control was transferred from physicians to the patients themselves. According to Dr. Berwick, we face a system...
"...built...around clinicians that makes it impossible to customize care the way it needs to be. We don’t have a standard of services or processes that are comfortable for patients. We have built a technocratic castle, and when people come into it, they are intimidated.

"Patients keep having to r…

GM Will Rue the Day It Converted Roger Penske From Partner To Competitor

Enduring another endless spasm of "Pursue scale! Eliminate overhead!! Damn the torpedoes!!!" a PPE (that's Prior Place of Employment to you newer readers) closed a nearby primary care practice in favor of a larger practice two towns over.

To the extent there was ANY rationality behind the decision, several theories appeared to apply: (1) solo practice is an expensive, uncompetitive model of organizing a medical practice, and (2) consumers would happily do what they're told even if it meant driving 30 minutes through grinding suburban traffic to see another PPE-branded doctor.

Both theories were quickly proved wrong. What was proven right (again) is the notion that markets are local - one service provider, one customer, a loyal dyad.

Some physicians prefer practicing solo, are good at it and don't mind the drawbacks, which can be substantial. So it was with this doc. He left us, established another solo practice nearby, joined our competitor's medical staf…

What If...

As I write this, in the aftermath of the Air France tragedy, the so-called black boxes' recovery from an unknown resting place thousands of feet under the waves is not certain. What if, I mused, a plane's vital operating statistics were streamed to a secure server somewhere, dry and on-shore?

Apparently it's not a new idea, in fact it's old enough to have come to Katie Couric's attention. Of all people, she covered it on the CBS news this evening, where I learned that, as with most things, the obstacles are not technical as much as financial (lots of planes, lots of data, lots of bandwidth, lots of servers) and organizational (pilots look at it as 'big brother' watching their every move in real-time.)

That's most often the case; new ideas are technically possible long before all the inertial barriers to implementation come down. I guess those arguing against the idea aren't paying the salvage team's salaries or braving mid-Atlantic storms, look…

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd.

Most important, in my opinion, is this:

"...electronic medical records will enable value improvement,but only if they support integrated care and outcome measurement.Simply automating current delivery practices will be a hugelyexpensive exercise in futility. Among our highest near-termpriorities is to finalize and then continuously update healthinformation technology (HIT) standards that include precisedata definitions (for diagnoses and treatments, for example),an architecture for aggregating data for each patient over timeand across providers, and protocols for seamless communicationamong systems.

"Finally, consumers must become much more involved in their health…

Let's Try This Again!

The health groups backing away from their commitment last week have now resurfaced with a list of what they'll do to reduce health care costs. For example,
"...the American Medical Association, which represents doctors, is proposing to curb what it deems "overuse" in areas including Caesarean sections, back-pain management, antibiotic prescriptions for sinusitis and diagnostic imaging tests...

"(Other) proposals from the groups involved include trying to reduce medical errors, switching to common insurance forms, improving measurements of physician performance, reducing the number of patients readmitted to hospitals, improving the efficiency of drug development, and expanding in-home care for patients with long-term illnesses."All look to be things already in progress at forward-thinking organizations, though it never hurts to gain extra political credit for what you were planning to do anyway.


6 Habits Of Effective Chief Strategy Officers

Paraphrasing a bit, here are six habits for highly effective Chief Strategy Officers...
Committing to the education and involvement of the C-suite and the Board.Influencing wisely.Assigning direct reports to be business unit ambassadors.Joining hands with business unit leaders at every opportunity.Advertising both your plan and the planning process that produced it.Making planning user-friendly for everyone.Other suggestions?