Archive for December, 2012



New Healthcare Models Stand “Standard of Care” on Its Head

December 18th, 2012
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As I watch the power in healthcare shift away from physicians/providers toward consumers/patients (enabled by the wide access to information and driven in part by higher co-pays), I can’t help but to observe the affects of the Affordable Care Act on both this new power and the bedrock concept of healthcare delivery—“standards of care”.
 
Rob Lamberts, a physician who switched his practice from fee-for-service to “direct care” (in which patients buy in as a member instead of paying for each procedure and visit, and receive a basic set of services), has compared the changes in healthcare delivery to the upheaval caused by digital cameras. Just as the move from film to digital imagery brought photography closer to the consumer, mobile apps and web-accessible information will move healthcare delivery closer to customers (a.k.a., patients). Film companies like Kodak failed to recognize the disruptive innovations wrought by digital photography; could consumer power provide the same disruptive innovation to healthcare? As healthcare industry expenses approach 18% of GDP, the unsustainable weight of healthcare costs practically beg for such a disruption.
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First HHS Innovation Fellowships’ Meeting Focuses on New Measures of Quality in Healthcare

December 10th, 2012
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In its quest to find ways to reduce healthcare costs but boost healthcare quality, the U.S. Department of Health and Human Services (HHS) launched its first fellowship program in September. For the next year, I’ll be a technical advisor on the part of this program that focuses on quickly developing ways to measure clinical quality under the new healthcare act.
 
I’ll be working on a team with Mindy Hangsleben, an innovator in Lean technology at Intel in Portland, Oregon. We’ll be examining the challenge presented by the Affordable Care Act, which aims to move reimbursements from “fee for services” to” fees for performance.” Our questions are: “how do you measure performance? How do you pay for it?” Some aspects of health care delivery are easier to measure; e.g., what percentage of the relevant population gets a mammogram. But basing performance upon a more holistic measure of patient outcomes is tricky because all patients are not equal, and a comparison and ranking of outcomes is not easy. In addition, we’ll be looking at ways to determine the role played by various electronic health records (EHRs) in the capture of these performance parameters, as required under the new Health Information Technology for Economic and Clinical Health (HITECH) Act.
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On Cleveland Clinic’s Top 10 Healthcare Innovations of 2013

December 5th, 2012
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Earlier this week, I reflected on the Cleveland Clinic predictions on the Top 10 innovations in healthcare for 2012 from the vantage point of the year coming to a close. Today, I’ll review the predictions for 2013:

     

  1. Healthcare programs with monetary incentives (Medicare Better Health Rewards Program)—Due to rising costs of healthcare, this program is designed to empower the patient to reach achievable health goals. Metrics gauge improvement in six areas: body mass index, diabetes indicators, blood pressure, cholesterol, vaccinations, and tobacco use. The program gives participants an incentive of up to $400 after they follow the program for two to three years. The rewards: better outcomes for seniors and reduced utilization of healthcare services. While this is not a medical device, it will be interesting to see results over the year ahead.
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The Top 10 Healthcare Innovations of 2012. How Well Did They Do?

December 3rd, 2012
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Last year, the Cleveland Clinic predicted what the Top 10 innovations in healthcare for 2012 would be. Before we report on the Cleveland Clinic’s predictions for 2013, let’s review how well the Top 10 Innovations for this year actually fared:

     

  1. Catheter-based renal denervation for resistant hypertension—Five companies are manufacturing the devices, which are now available in Europe and are under study in the U.S.
  2. CT scans for early detection of lung cancer—New practice guidelines recommend screening using low-dose CT scans for people at high risk of developing lung cancer and can only be performed in experienced facilities. The cost? About $100 per screening (not covered by insurance).
  3. Concussion management for athletesThe Cleveland Clinic is developing a concussion app for use in high schools that checks athletes’ memory, reaction time, and balance and compares scores to previous data points.  Read the rest of this entry »

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