A blog covering the health/care ecosystem and people.

When it comes to health care, more American voters trust Hillary Clinton to deal with health issues than Donald Trump, according to the Kaiser Health Tracking Poll: August 2016 from the Kaiser Family Foundation (KFF). The poll covered the Presidential election, the Zika virus, and consumers’ views on the value of and access to personal health information via electronic health records. Today’s Health Populi post will cover the political dimensions of the August 2016 KFF poll; in tomorrow’s post, I will address the health information issues. First, let’s address the political lens of the poll. More voters trust Hillary Clinton to do

When a person dons a piece of wearable technology, they first look to engage with some aspect of health or fitness before they seek entertainment. To satisfy that demand side of the market equation, we’re seeing a stream of devices, platforms, and corporate strategies trying to reach the wearable tech consumer. Today, Philips announced its expanding strategy for digital health, launching devices to help people, in Philips’ words, measure, monitor, and stay motivated for personal health. The company is offering a health smartwatch, a weight scale, an ear thermometer, and two blood pressure monitors (for wrist and upper arm), all

Investing information technology dollars in telehealth and mobile platforms, patient engagement, and cybersecurity are major focuses for leading IT-savvy hospitals in America, according to the 2016 Most Wired survey of healthcare organizations, released in July 2016 sponsored by Hospitals and Health Networks and Health Forum, a division of the American Hospitals Association. This survey, in its 18th year, has become an important benchmark measuring the adoption of information technology tools and services among American hospitals and health systems. The complete list of Most Wired hospitals for 2016 can be found here. The most popular telehealth services offered by the Most Wired hospitals are

Digital platforms and tools are fast-advancing in all industries, and especially in health and health care. But it’s people-first, and digital PLUS analog, based on Accenture’s latest forecast of five macro technology trends. The five forces are: Intelligent automation – 70% of health executives expect to invest more in artificial intelligence; Liquid workforce – 42% of health/care workers are expected to be contractors or free agents within organizations within 3 years’ Platform economy – 10x growth is expected in application programming interfaces (APIs) in the next five years, which will enable data to liquidly move across healthcare platforms Predictable disruption

Faxing in health care ranks higher in patient data information sharing than using secure email, online portals, health information exchange (HIE), or leveraging electronic health records. Welcome to the American healthcare system in 2016, as described in a market spotlight published by IDC, The Rocky Road to Information Sharing in the Health System. IDC’s survey research among healthcare providers forecasts the “rocky road” to information sharing. That rocky road is built for medical errors, duplication of services, greater healthcare costs, and continued health il-literacy for many patients. “The holy grail of interoperability — lower-cost, better-quality care with an improved experience for

“Consumers expect to have their data available and shareable.” Two essays in two issues in the past two weeks of The New England Journal of Medicine point to the importance of patients – people, caregivers, consumers, all — in the morphing “health information economy,” a phrase used in the title of one of the published pieces. In Time for a Patient-Driven Health Information Economy, Dr. Ken Mandl and Dr. Isaac Kohane, who are both affiliated with the Department of Biomedical Informatics at Harvard, discuss peoples’ growing interest in engaging with their personal health information, noting frustrating barriers to doing so:

“There’s no such thing as a healthcare consumer. No one really wants to consume healthcare,” naysayers tell me, critical of my all health-consmer-all-the-time bully pulpit. But, touché to my health consumer-critics! I’ve more evidence refuting the healthcare consumer detractors from McKinsey in their research report, Debunking common myths about healthcare consumerism, from the team working in McKinsey’s Healthcare Systems and Services Practice. Their survey research among over 11,000 U.S. adults uncovered 8 myths about the emerging American health consumer, including: Healthcare is different from other industries Consumers know what they want from healthcare and what drives their decisions Most consumers

When most patients in the U.S. visit their doctors, they find their medical history missing or incomplete. 1 in 2 American patients say their doctors do not have a complete list of their medications. But the new health consumer expects a connected health experience the likes of which, as consumers, they expect and generally find in their everyday lives. One-half of consumers would prefer to get lab test results, access their medical records, and fill out paperwork from a doctor’s office ahead of a visit online versus via phone or in person. Surescripts conducted a survey with Kelton Global in

In the growing shared economy, one centerpiece is people-powered health – co-creating, shared decision-making, and a greater appreciation for the impact of social on health. As we approach the mid-point of 2015, there are several signposts pointing to people-powered health/care. FasterCures launched the Science of Patient Input Project, with the objective of getting the patient’s voice into clinical discovery and decision-making. This video describes the intent of the program and its potential for people-powered health and user/patient-centered drug design, beyond the pure clinical efficacy of therapies. Another example of people-powered health comes from The Wall Street Journal dated 29 June 2015, which

In recent weeks, an enormous amount of money has been raised by organizations using information technology to move health/care to people where they live, work, and play… This prompted one questioner at the recent ANIA annual conference to ask me after my keynote speech on the new health economy, “Is the hospital going the way of the dinosaur?” Before we get to the issue of possible extinction of inpatient care, let’s start with the big picture on digital health investment for the first quarter of 2015. Some $429 mm was raised for digital health in the first quarter of 2015,

  George Bush was the keynote speaker yesterday at HIMSS in Chicago at McCormick Place. As expected and appropriate, the Secret Service detail was at-the-ready to ensure the President’s safety and security.  In the morning, members of the press were told by HIMSS’s communications staff that we would be able to watch the speech, live streamed, in the press room, able to cover the event in detail: words have meaning, and many of us were keen to hear how this President, who ushered in the early era of electronic health records, viewed healthcare and information technology then, and now. A fascinating

This was not a theoretical question Dr. Farzad Mostashari, former head of the Office of the National Coordinator of Health IT in the Department of Health and Human Services, asked yesterday at the closing keynote of Day 1 of the Patient Engagement Forum. Dr. Mostashari issued a challenged to the community of mischief-makers in health/tech patient advocacy: tell everyone you know to contact their doctors — by phone, email, patient portal, or in-person, on one designated day which he called a “Day of Action.” Health IT journalist Neil Versel (disclosure: also a long-time friend in the field) covered this news

Health is the hot topic at SXSW. While edgy new movies and hot music are the foundational elements of the annual South-by-Southwest festival, health and health care are the fast-growing themes at the meet-up, where the new-new, month-old beautiful JW Marriott Hotel by the Convention Center hosted most of the digital health track sessions. Digital health today goes well beyond mobile apps and genomic futures. Philips was a major presence this year at SXSW with its vision, shared by me, THINK-Health, and the HeathcareDIY team, of connected health where we live, work, play, pray and learn. In the case of

Just 1 in 5 health-insured people with a primary care provider use the web to look at their health data, and fewer than 1 in 10 people use digital means to book appointments. Welcome to the 2015 State of the Connected Patient, a survey report from Salesforce conducted by Harris Poll among 2,095 adults in January 2015. Perhaps the title of the analysis should more appropriately be the “2015 State of the Unconnected Patient.” While most patients polled are satisfied with their PCPs and most believe doctors are sharing their health records, people lack digital engagement with their primary care providers.

Doctors and hospitals live and work in a parallel universe than the consumers, patients and caregivers they serve, a prominent Chief Medical Information Officer told me last week. In one world, clinicians and health care providers continue to implement the electronic health records systems they’ve adopted over the past several years, respond to financial incentives for Meaningful Use, and re-engineering workflows to manage the business of healthcare under constrained reimbursement (read: lower payments from payors). In the other world, illustrated here by the graphic artist Sean Kane for the American Academy of Family Practice, people — patients, healthy consumers, newly insured folks,

There’s growing interest among both consumers and clinicians in people DIY’ing healthcare. Consumers are even keener than their doctors about the self-care concept, PwC’s Health Research Institute has found. Doctors who are already in value-based payment mode — participating in accountable care organizations, at-risk for reimbursement, doing population health — are earlier adopters of digital health tools that enable patients to care for themselves outside of the health care setting. These providers are also working more on care teams, where physicians can work at their ‘highest and best use,’ complemented by nurse practitioners, physician assistants, diabetes educators, and other ancillary

Dr. Joseph Kvedar has led the Center for Connected Health for as long as I’ve used the word “telehealth” in my work – over 20 years. After two decades, the Center and other pioneers in connected health have evidence proving the benefits, ROI (“hard” in terms of dollars, and “soft” in terms of patient and physician satisfaction), and technology efficacy for connecting health. The 11th Annual Connected Health Symposium is taking place as I write this post at the Seaport Hotel in Boston, bringing health providers, payers, plans and researchers together to share best practices, learnings and evidence supporting the

More than twice as many patients than physicians are embracing consumers’ use of new digital technologies to self-diagnose medical conditions on their own. On the other hand, 91% of doctors are concerned about giving patients access to their detailed electronic health records, anticipating patients will feel anxious about the results; only 34% of consumers are concerned about anxiety-due-to-EHR-exposure. Welcome to the digital health chasm, that gap between what consumers want out of digital health, and what doctors believe patients can handle at this stage in EHR adoption in doctors’ offices and in patients’ lives. I have the video of Jack

There’s a health information disconnect among U.S. adults: most people believe online access to their personal health information is important, but three-quarters of people who were offered access to their health data and didn’t do so didn’t perceive the need to. The first two graphs illustrate each of these points. When people do access their online health records, they use their information for a variety of reasons, including monitoring their health (73%), sharing their information with family or care providers (44%), or downloading the data to a mobile device or computer (39%). In this context, note that 1 in 3

Patients are concerned about private risks of personal health data, resulting in some patients not disclosing certain information to health providers to protect their perceived EHR privacy and security risks. Peoples’ mixed feelings about sharing personal health information with their providers and EHRs is explored in The double-edged sword of electronic health records: implications for patient disclosure, published in the July 2014 issue of JAMIA, the Journal of the American Medical Informatics Association (AMIA). “The perception of the [EHR] technology may elicit non-disclosure as a privacy-protecting behavior,” the authors warn. Celeste Campos-Castillo and Denise Anthony, the paper’s researchers who work in

“For Big Data, Big Questions Remain,” an article by Dawn Falk in the July 2014 issue of Health Affairs, captures the theme of the entire journal this month. That’s because, for every opportunity described in each expert’s view, there are also obstacles, challenges, and wild cards that impede the universal scaling of Big Data in the current U.S. healthcare and policy landscape. What is Big Data, anyway? It’s a moving target, Falk says: computing power is getting increasingly powerful (a la Moore’s Law), simpler and cheaper. At the same time, the amount of information applicable to health and health care

“Telehealth isn’t about seeing a provider by video: it’s about decision making,” Dr. Adam Darkins, leader of the U.S. Department of Veterans Affairs National Telehealth Programs, told the audience in his keynote address at the Government Health IT Conference in Washington, DC, on June 17, 2014. Dr. Darkins, trained as a neurosurgeon, realized earlier in his career “time and again,” he said, that he should have seen his patients more frequently in-between face-to-face visits. “A good decision downstream can make a lot of difference to someone’s longevity,” Dr. Darkins recognized. He’s worked with a team at the VA to build

Open data is a growing trend in health care. Analyzing data sets across lots and lots of people can help researchers identify medical cures, anticipate epidemics, and solve knotty problems where social and behavioral issues complicate clinical questions and solutions. Joining the open health data community is the health IT company Practice Fusion, which is sharing with the public aggregated data on some 81 million patients collected through over 100,000 active users every month recording patient data in the company’s cloud-based electronic health records system. Insight, the searchable database, is freely available to people, researchers, policymakers, and anyone who wants to look at top line

When Mary Meeker talks, the digerati listen. Meeker is the digital industry analyst who’s a partner at KPCB, a venture capital company, in Silicon Valley. Each year she publishes a report on the state of the digital marketplace. Her 2014 paper, Internet Trends 2014 – Code Conference (dated May 28 2014)  is online, and as usual, it’s full of data points on both digital technology segments along with some vertical industry findings – in education, financial services, and health, among other segments. I’ve combed through the 164 pages of the PDF to trend-weave the health implications. When it comes to health, the

The CEO of a family-owned grocery store chain wrote a letter to New York State lawmakers to support $65 million worth of spending on a computer system for health information in the state. That grocer is Danny Wegman, and that project is the Statewide Health Information Network, aka SHIN-NY. In his letter beginning, “Dear New York Legislator,” Wegman identifies several benefits he expects would flow out of the health IT project: 1. Improve health care for all New Yorkers 2. Lower health care costs, through reducing hospital readmission rates and reducing duplicate testing. 3. Lead to health data “liquidity” (my

That’s a useful and timely question, given the news that Castlight Health will launch its IPO with valuations north of $1 billion. Yes, “billions,” and according to a  MarketWatch analysis, “it’s a bargain at $1 billion.” So then – do we anticipate a bubble? asked Marc Monseau of the Mint Collective, the convener of our panel who brought together Robert Stern, a successful health-tech entrepreneur whose latest venture, @PointofCare, focuses on patient engagement; Marco Smit of Next Innovation Health Partners (parting from the Health 2.0 Conference family where he led Health 2.0 Advisors for several years); and me. Some key

Today kicked off the 2014 South-by-Southwest Festival (#SXSW) in Austin, TX, running until March 16 and featuring dozens of sessions, concerts, video, and fireside chats in music, film and interactive segments. I’ll be involved in an interactive session on Tuesday called “The Digital Health Bubble – Is It About to Burst?” This panel includes Marc Monseau (@MDMonseau) who is a pioneer in health and social media (building J&J’s early leadership in social health online); Marco Smit (@MrHealth20) who leads Health 2.0 Advisors and is a veteran strategist in several health/tech companies; and, Robert Stern, Founder/CEO of @PointofCare, a health IT platform that

Returning to terra firma following last week’s convening of the 2014 annual HIMSS conference…taking some time off for family, a funeral, the Oscars, and dealing with yet another snowstorm…I now take a fresh look back at #HIMSS14 at key messages. In random order, the syntheses are: Healthcare in America has entered an era of doing more, with less...and health information technology is a strategic investment for doing so. The operational beacon going forward is moving toward The Triple Aim: building population health, enhancing the patient’s experience, and lowering costs per patient. The CEO of Aetna, Mark Bertolini, spoke of the

Even before stepping into the Orlando Convention Center on Sunday 23 February 2014, my clairvoyant powers know the forecast of the Best in Show: the growing role of patients in health care, reflected in both the education session at the annual 2014 meeting of HIMSS as well as the product/service mix being proffered on the convention show floor. As a member of HIMSS Connected Patient Committee, I know first-hand the conscious effort and energy that the organization has committed to getting real about patients’-peoples’-caregivers’ central role in health care. The organization was built on providers and technology. When I first

IBM’s data analytics engine Watson, having cut its teeth on complex health care conditions like cancer, is now entering an even more challenging space: wellness. Why is wellness more challenging? Because understanding a person’s wellness goes beyond mining data from health care claims silos in hospitals, pharmacies, and physicians’ electronic health records. Wellness happens where we live, work, play and pray. Wellness is nurtured through choices made every day at home, in the workplace, and at moments-of-truth in the grocery store and restaurant where slick marketing messages planted in our subconscious compete with our more rational minds that tell us to

The convergence of technology developments – such as the internet, mobile phone adoption, cloud computing, sensors, electronic health records – with societal evolution including consumerism, demand for transparency, and “flatter” organizations – enable the phenomenon of Connected Health. Connected Health by definition includes mobile health (mHealth), telehealth and telemedicine, as presented in the February 2014 issue of Health Affairs which is dedicated to this theme. Why Connected Health’s time is Now relates to those factors cited above, and the underlying challenge of managing health care costs. While all nations in the developed world are facing difficult health economies, the U.S. spends so

When the head of the Consumer Electronics Association gives a shout-out to the growth of health products in his annual mega-show, attention must be paid. The #2014CES featured over 300 companies devoted to “digital health” as the CEA defines the term. But if you believe that health is where we live, work, play, and pray, then you can see health is almost everywhere at the CES, from connected home tech and smart refrigerators to autos that sense ‘sick’ air and headphones that amplify phone messages for people with hearing aids, along with pet activity tracking devices like the Petbit. If

The 2013 Mobile Health Summit was hosted by HIMSS at The Gaylord Resort in suburban Washington DC, taking place over 4 days during the mid-atlantic region’s iciest conditions in years. But inside the cocoon of this convention space, 5,000 conveners took in demonstrations of innovations using mobile platforms and standards that extend health services, knowledge and self-help tools to people and providers. Several themes emerged out of the meeting… Lots of apps, too few business models.  There are too many apps and not enough companies, Esther Dyson noted in a keynote session during which she dialogued with two Steve’s: Steven

At the Venture+ Forum at the 2013 Mobile Health Summit yesterday, Lisa Suennen, Managing Director of Psilos Ventures was asked what she and her venture capital fund look for in choosing new investments for their health care portfolio. She succinctly said, “technologies that lower costs.” With nearly $1 in $5 of the U.S. economy attributable to health spending, Lisa’s got a point. Technology in U.S. health care has been mostly additive and expense-inducing, not reducing: fax machines and printers, for example, continue to proliferate in health care settings as part of “networking,” and once you add a new clinical technology

If Californians represent their American peers, then most people in the U.S. want to access their health information online, based on findings in Health Information Technology in California: Milestones and Miles to Go, a report from California HealthCare Foundation published on 6 November 2013. Interviews among 319 California residents conducted in February 2013 found that: 3 in 4 people believe an electronic health record (EHR) is a valuable tracking tool 85% of people say doctors should have access to a patient’s personal health information – but 49% say “my health records are for my own use and should not be

Consumers embrace ongoing dialog with the companies they do business with, Varolii Corporation toplines in a survey report, What Do Customers Want? A Growing Appetite for Customer Communications. Across all vertical industries consumers trust for this dialogue, health care organizations – specifically doctors, pharmacists, and insurance companies – are the most trusted. Examples of “welcome-comms” would be reminders about upcoming appointments or vaccinations (among 69% of people), notices to reorder or pick up a prescription (57%), and messages encouraging scheduling an appointment (39%). In banking, notices about fraudulent activity on one’s account is the most welcomed message beating out appointment

Where can you shop the health and beauty aisles, pick up some groceries and a prescription, get a flu vaccine, and weigh in on Obamacare and what digital health tools you like? Why, at one of several thousand retail stores where you can find a SoloHealth kiosk. As of yesterday afternoon, over 32 million encounters were recorded on SoloHealth kiosks, based on an app I saw on the company CEO Bart Foster’s smartphone. Kiosks are locatted around the United States in retailers including Walmart and Sam’s Clubs, along with major grocery chains like Schnuck’s and Publix, and the CVS pharmacy

A cadre of pioneering Americans has been meaningfully using personal health information technology (PHIT), largely outside of the U.S. health care system. These applications include self-tracking and wearable health technologies, mobile health apps, and digital medical tracking devices like glucometers that streamline tracking and recording blood glucose levels. In the meantime, only 21% of doctors surveyed by Accenture currently allow patients to have online access to their medical summary or patient chart – very basic components of the electronic health record. We know what’s primarily driving health providers’ adoption of health IT: namely, the HITECH Act’s provisions for incentives. But

In game-scoring unit terms, 52 is the number of hours an average American spends seeking health information online each year. The 1 (hour) is roughly equivalent to the approximate total time a patient spends with a physician (an average of 3 visits, with an average time per vision of 20 minutes). Thus, 52:1. This means that the average U.S. health consumer spends much more time DIYing her health using digital information resources than speaking face-to-face with their physician in the doctor’s office. Still, the physician continues to be a go-to source for health information, according to Makovsky, a health communications

Imagine walking into a storefront where you can shop for an arthroscopy procedure, mammogram, or appointment with a primary care doctor based on price, availability, quality, and other consumers’ opinions? Welcome to the “health care automat,” the online healthcare marketplace. This is a separate concept from the new Health Insurance Marketplace, or Exchange. This emerging way to shop for and access health care services is explored in my latest paper for the California HealthCare Foundation (CHCF), Help Yourself: The Rise of Online Healthcare Marketplaces. What’s driving this new wrinkle in retail health care are: U.S. health citizens morphing into consumers,

Tablets, wearables, smartphones, video and QR codes: these are fast-growing platforms moving data around the global economy. They’re also fast=growing platforms for health care where we live, work, play and pray. Mary Meeker’s annual presentation on Internet Trends at the D11 Conference, is fresh off the virtual press in its shiny new 2013 version. Meeker has been with the investment firm Kleiner Perkins Caulfield Byers (KPCB) since 2011, and was with Morgan Stanley from 1991 to 2010. She’s a veteran who’s watched the Internet basically from The Beginning. Of the 117 slides in her informative, gargantuan deck (a Meeker hallmark every

Why has health cost growth in the U.S. slowed in the past few years? It’s mostly due to the economy, argues the Kaiser Family Foundation in Assessing the Effects of the Economy on the Recent Slowdown of Health Spending. The answer to this question is important because, as the American economy recovers, it begs the next question: will costs increase faster once again as they did in previous go-go U.S. economies, further exacerbating the budget deficit problems in the long-term? KFF worked with Altarum to develop an economic model to answer these questions. The chart illustrates the predicted vs. actual

  Patient satisfaction survey scores have begun to directly impact Medicare payment for health providers. Health plan members are morphing into health consumers spending “real money” in high-deductible health plans. Newly-diagnosed patients with chronic conditions look online for information to sort out whether a generic drug is equivalent to a branded Rx that costs five-times the out-of-pocket cost of the cheaper substitute. While health care report cards have been around for many years, consumers’ need to get their arms around relevant and accessible information on quality and value is driving a new market for a Yelp, Travelocity, or Zagat in

While health care cost growth has slowed nationally, most Americans feel they’re going up faster than usual. 1 in 3 people believe their own health costs have gone up faster than usual, and 1 in 4 feel they’re going out about “the same amount” as usual. For only one-third, health costs feel like they’re staying even. As the second quarter of 2013 begins and the implementation of the Affordable Care Act (ACA, aka “health reform” and “Obamacare”) looms nearer, most Americans still don’t understand how the ACA will impact them. Most Americans (57%) believe the law will create a government-run health plan,

I endured what very few people could (or would) do in the past ten days: I traveled to New Orleans to the annual conference of HIMSS, the Health Information Management Systems Society, which features hundreds of suppliers to the health care information technology industry. I returned home to kiss my family hello and goodbye, and a day later flew to Austin for the annual South-by-Southwest conference for music, movie and digital folks. The health track at SXSW has grown over the past five years, and provides a start contrast to “health care” as embodied at HIMSS, and “health” translated through

Wearing his Walking Gallery jacket painted by (im)patient advocate, Regina Holliday, Dr. Eric Topol evangelized the benefits of digital medicine and consumer empowerment in health care, largely summarizing his epic (pun intended – wait for Hot Point, below) book, The Creative Destruction of Medicine. A founder of the West Wireless Health Institute (now known as West Health), Dr. Topol is a physician and researcher at Scripps and was recently named as editor at Medscape. A new piece of Topol Trivia for me is that GQ magazine called him a rock star of science. Dr. Topol is one of the more

Patients are getting comfortable with remote health care – that is, receiving care from a health provider at a distance via, say, telehealth or via a Skype-type of set-up. Furthermore, 70% of people globally saying they would trust an automated device to provide a diagnosis that would help them determine whether or note they needed to see a doctor. Based on the findings from Cisco‘s survey summarized in the Cisco Connected Customer Experience Report – Healthcare, published March 4, 2013, just-in-time for the annual 2013 HIMSS conference, a majority patients the world over are embracing health care delivered via communications

Traditional venture capital in health care is so 2010: welcome to The Greenhouse Effect: How Accelerators Are Seeding Digital Health Innovation, explained in a new report from California HealthCare Foundation written by Aaron Apodaca. Aaron clearly explains the growing interest in and influence of health accelerators, which grew out of the first era of the Internet (read: dot-com bust v 1.0) and the founding of the Y Combinator, an internet incubator that made relatively small investments in exchange for equity positions in start-ups. Health accelerators emerged around 2011, first with Rock Health in San Francisco, which was quickly followed by

A vast majority – 9 in 10 physicians – like mobile health (mHealth) apps, especially when tied to electronic health records (EHRs). eClinicalWorks surveyed physicians in January 2013, and found physicians bullish on mobile health apps for patient benefit – not just for their own office productivity and workflow. Specifically, – 93% of physicians say mobile health apps can improve patients’ health outcomes – 89% of physicians would recommend an mHealth app to a patient – 58% of doctors note a key mHealth benefit is providing patients with appointment alerts and reminders – 2 in 3 physicians say mHealth apps