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Showing posts from June, 2011

The Future May Be Ultrawideband

Via EurekAlert: "New research by electrical engineers at Oregon State University has confirmed that an electronic technology called "ultrawideband" could hold part of the solution to an ambitious goal in the future of medicine – health monitoring with sophisticated "body-area networks."


"The ideal device would be very small, worn on the body and perhaps draw its energy from something as minor as body heat. But it would be able to transmit vast amounts of health information in real time, greatly improve medical care, reduce costs and help to prevent or treat disease."


Wellpoint Buys CareMore Health Group and Why You Should Care

LA Times: "Cerritos healthcare provider CareMore Health Group is being acquired by health insurance giant WellPoint Inc. for about $800 million as part of an effort to bolster the insurer's profile in senior care as baby boomers age."

Like with the Humana-Concentra deal, insurers have a vision for value-driven health care that's quite different from most hospitals' 'let's avoid it until Medicare sweetens the pot' posture.
"The deal, announced Wednesday, will give WellPoint a boost as it competes for a piece of the fast-growing elderly care market, said Ana Gupte, an analyst with New York research firm Sanford C. Bernstein.

"They've purchased a company that has a strong record of managing chronic disease and clinics that specialize in caring for seniors," Gupte said."Hospitals are in full-blown dither mode about ACOs.  Should we or shouldn't we?  Now? Next year? Never?  Ever?  Some caution is probably appropriate at this point…

A Flash For the Policy Wonks Pushing ACOs

The Health Care Blog: Why ACOs Won't Work.
"Here’s a flash for the policy wonks pushing ACOs: They only work if the provider gets paid less for the same patient population. Why would they be dumb enough to voluntarily accept that outcome?

"Oh, there will be some providers—particularly hospital administrators—who can’t wait to build an ACO but probably more because they want another excuse to corner the primary care docs as a marketing channel for their growing system. But spend millions to develop an ACO so they can get less money? Only in the policy wonk netherland does that compute."ACOs or not, we're heading for an era where declining reimbursement meets increasing demand, where value and productivity are the keys to survival.

Continuously Improving Communications

A few years ago I decided to conduct a readership survey of the audiences - employees, physicians and volunteers -  for my internal newsletters.  At the time, much like you probably do, we published all sorts of content about important-sounding decisions, committees and strategies.  It was important to us, ergo it was important to them.

Can you guess what we found?  Volunteers paid a little attention, physicians almost none.  (Of course we were soon producing an equally-ignored physicians' newsletter...another story for another day.)  Employees tuned in mainly for...the cafeteria menus!  Yikes!  But we learned some important lessons and got better.  So can you.
What questions are you asking to foster continuous improvement in your communications strategy?  Are you building metrics around the answers to those questions?  Do you have technology in place to generate the data to drive the metrics?
What questions SHOULD you ask to listen, learn and improve? A modest list, in no particul…

Innovators Tackle Ventilator-Associated Pneumonia

From Queen Mary, University Of London (via EurekaAlert!):   A team from Queen Mary, University of London and Barts and The London NHS Trust has been named overall winner in the Respiratory Innovation category at the Medical Futures Innovation Awards, Europe's leading showcase of early-stage innovation in healthcare.
"The research team, most recently co-ordinated by Dr Joanne Stewart from Queen Mary, University of London invented a Nitric Oxide generating technology for prevention of ventilator associated pneumonia in intensive care patients. The system simply replaces the natural defence molecules which are critically low in these patients, and protects against infection. It is able to penetrate into the body tissues, and kills a wide variety of infective agents, including MRSA and E. Coli."Hospitals working to prevent ventilator-associated pneumonia (and most of them are or should be) might want to take note.

Physicians Oppose NY's Palliative Care Information Act

NY Times: New York State's physicians "vehemently" oppose the state's new Palliative Care Information Act:
"...when patients are found to have a terminal illness or condition, health care practitioners must offer to provide information and counseling about appropriate palliative care and end-of-life options. Patients or their surrogates are entirely at liberty to refuse an offer to discuss these options."


"Doctors are notorious death-deniers, often more reluctant than their patients to admit that it is pointless to pursue treatment that is medically futile. They either fail to mention hospice care or suggest it far too late — usually within a week of death, when hospice personnel have little time to get to know the patient and family and to provide the kind of care that can make for a graceful exit from this world."In the end, legislators acted when many physicians would not.

We're All Social Now!

Why does 'social' matter in health care?  Imagine moving to a new town and needing a pediatrician for your kids.  You ask a few new friends and coworkers, who all say "Dr. Smith is the best."  Then you see a hospital's newspaper ad introducing Dr. Jones.

4 personal recommendations for Dr. Smith, an ad for Dr. Jones. Which do you select?

When Geek Squad founder Robert Stephens says "Advertising is the price you pay for a bad idea." he's saying that we're more likely to act on information from our social networks than from old-style interruption advertising.

The fact that conversations now occur electronically instead of over the back fence doesn't change the inescapable fact: we are social creatures.  We think socially, we learn socially and we act socially.

By one estimate, roughly 1,000 hospitals have some social media presence.  How many truly ACT socially when nurses are trusted with critically-ill patients but not with Twitter?  


Connecting the Dots

"You can't connect the dots looking forward you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something: your gut, destiny, life, karma, whatever. Because believing that the dots will connect down the road will give you the confidence to follow your heart, even when it leads you off the well worn path."

(Steve Jobs (1955 - ), Stanford Commencement Address, 2005)

Education, Defined

"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't."

(Anatole France, 1844 - 1924)

The Weekend In Ideas and Innovation

Booz&Co: Middle managers hold the key to reinvigorating a stalled innovation pipeline.

H&HN Daily:  Can your hospital handle the truth? Biotech startup pharmaCline launches its first-aid antibiotic topical ointment venture in S.F.  You're probably not surprised, except here it's Sioux Falls, SD.

NY Times: Medical school should be free.

MedCity News: 27 million Americans battle osteoarthritis. Now, Madison, Wisconsin-based Flex Biomedical may have a "disruptive technology" for improved treatment.  Human trials begin next year as the company seeks $5 million from a strategic investor.

Also from MedCity News: How relevant are VCs and their money to early-stage med tech startups? 

Pharmacogenomics Reporter: Clayton Christensen develops his disruptive innovation theory into a Roadmap for Personalized Health Care.  Look for an online release later this year.  More from Christensen at;
"Companies do not routinely disrupt themselves, simp…

Design and Usability Are Critical To Mobile Health's Success

From Brian Dolan at MobiHealth News:  Health devices that are easier to use find greater acceptance among patients. (And) those patients surveyed said they were mostly willing to pay more for user friendly devices.
“There are some great wellness and fitness apps out there… if you want an app to help you get and stay active, you’re spoiled for choice,” Massive Health’s Sutha Kamal wrote earlier this year. “But what if you’re actually ill? Then there’s nothing sleek or sexy to help you manage your disease. You’re back to the world of clinical health applications that aren’t especially friendly, easy to understand or use, and certainly aren’t social. Today’s apps don’t appreciate that you’re a person. That’s simply not good enough.”[...more...]

Who develops wellness and fitness apps? Entrepreneurs and passionistas. Who develops clinical apps? IT types and clinicians, many of whom struggle mightily to spell words like  c-o-n-s-u-m-e-r.

Using Data to Improve Health: Live Webcast

From the Institute of Medicine and the Department of Health and Human Services, watch a live webcast on "Harnessing the Power of Data to Improve Health."

When: Thursday June 9, 2011, 9:00am EDT
Where: Watch the Live Webcast: or

Who:  Featured Speakers: Aneesh Chopra, US CTO; Tim O'Reilly, O’Reilly Media; Matt Miller, NPR; Harvey Fineberg, IOM President; Todd Park, HHS CTO; and many others.  The Health Data Initiative is a public-private collaboration that encourages innovators, entrepreneurs, startups, data geeks, community activists and policy makers to utilize health data to develop products and applications to raise awareness of health and health system performance and spark action to improve health.

What:  On June 9th the Department of Health and Human Services and the Institute of Medicine will hold a second health data forum that will bring together over 500 people in person to showcase how health data can create t…

A Reform-Based Innovation Portfolio

Sg2: Optimizing Innovation in the Reform Era.

"Health care systems may choose to manage innovation projects "right," when they would do better to manage the right innovation projects. While many organizations have processes for the former option, managing projects on time and in budget, true optimization of an innovation competency requires beefing up the latter option. This means maintaining an innovation portfolio, engaging in a dynamic process of evaluation, choice and project prioritization based on risk constraints, market trends and value derivation."

(Graphic: Sg2)

Marshfield Clinic Tops Medicare's Demonstration Program

Washington Post: Wisconsin's Marshfield Clinic is the big winner in Medicare's "performance payment" demonstration program, though overall the experiment failed to save a substantial amount of money.

[Read more here...]

Is Healthcare A Drag?

Yes, says McKinsey in this article on reducing the drag on the American Economy.  Fixing healthcare is first on the agenda.

GDP growth is not going to happen "...until we free ourselves from four anchors that have acted as a drag on growth in this country for many years now: lagging productivity in healthcare, education, energy and infrastructure, and government services."


"In 2008, the United States spent $2.3 trillion on healthcare—that’s more than we spent on food, and more than China spent on everything. Adjusted for population, we spend $650 billion more on healthcare than any other developed country, yet our outcomes are no better. Much of this $650 billion in excess costs is driven by characteristics of our system that have proven difficult to change, including unusually high costs for outpatient programs, local market oligopolies, a failure to apply known best practices, price-insensitive patients who don’t see the cost of their healthcare and contribute lit…

How Busy Will Your ER Be Next Week?

Peer into the future with "social sickness tracking."   From Fast Company:
"The most obvious manifestation of social sickness tracking can be seen with Sickweather, a new startup that mines data from Twitter, Facebook, and user input to show which illnesses are going around in your local area--and in your friend group. The service explains, "just as Doppler radar scans the skies for indicators of bad weather, Sickweather scans social networks for indicators of illness."Google's Flu Trends was probably the first resource built on the idea that certain search terms are good indicators of disease activity.  Says Google,
"We have found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. Of course, not every person who searches for "flu" is actually sick, but a pattern emerges when all the flu-related search queries are added together. We compared our query counts with traditio…

Hospitals: "More Pay, Less Risk Please!"

Leave it to hospitals to tell their biggest customer how to run its business.

Let me set the stage: As a high-volume purchaser of health care, Medicare is the hospital industry’s CUSTOMER. Hospitals are little more than mostly interchangeable, price-taking SUPPLIERS. Why is that important?

Predictably (now that reimbursement is at stake) hospitals have pushed back against Medicare’s ACO rules. Too risky, too prescriptive, too little uncertain benefit for too much expensive work, say the hospitals.

Now I can think of dozens of improvements to the ACO concept, things I would’ve done differently or in a less-clumsy way. Mysteriously, the Feds didn’t consult me (!) but now they’re holding firm to their rules, as they should.

It’s their money, after all.

And the message is clear: ACOs are not for everybody, not now, maybe not ever.   Like it? Fine. Don’t like it? Go play in someone else’s sandbox.

I call that clarity.

Hospitals, meanwhile, are acting betrayed.

“Darn customers! We had ‘em w…