A blog covering the health/care ecosystem and people.

In the U.S., “Health care is complicated because complexity is profitable.” So explain Bob Kocher, MD, and Anuraag Chigurupati, in a viewpoint on Economic Incentives for Administrative Simplification, published this week in JAMA. Dr. Kocher, a physician who is a venture capitalist, and Chigurupati, head of member experience at Devoted Health, explain the misaligned incentives that impede progress in reducing administrative spending. This essay joins two others in the October 20, 2021 issue of JAMA which highlight administrative spending in American health care: Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care by Nikhil Sahni, Brandon

The coronavirus pandemic disrupted and re-shaped the annual CES across so many respects — the meeting of thousands making up the global consumer tech community “met” virtually, both keynote and education sessions were pre-recorded, and the lovely serendipity of learning and meeting new concepts and contacts wasn’t so straightforward. But for those of us working with and innovating solutions for health and health care, #CES2021 was baked with health goodness, in and beyond “digital health” categories. In my consumer-facing health care work, I’ve adopted the mantra that our homes are our health hubs. Reflecting on my many conversations during CES

More U.S. doctors are using digital health tools in patient care, with quickening adoption of telehealth and remote monitoring technology, according to a study from the American Medical Association (AMA). This survey, conducted in 2019 among 1,359 U.S. physicians, follows up AMA’s research conducted in 2016 and largely reflects the original questionnaire to be able to understand real changes among doctors’ use of tech in practice. As part of this rigorous study design, AMA used particular definitions for the seven tools the study gauged: remote monitoring for efficiency, remote monitoring and management for improved care, clinical decision support, patient engagement,

Across generations, from younger to older patients, cost, transparency and convenience drive consumer satisfaction, Accenture’s latest health consumer survey found. I had the opportunity to brainstorm the study’s findings in real-time on the day of survey launch, 12 February, with Dr. Kaveh Safavi, Brian Kalis, and Jenn Francis at HIMSS19. Our starting point was the tipping-point statistic that over 50% of people in the U.S. have chosen to use a non-traditional health care setting. Those non-traditional sites of care include walk-in and retail clinics, outpatient surgery centers, virtual health (whether on the phone, on video or via mobile apps), on-demand services,

Doctors have a complicated relationship with electronic health records (EHRs): two-thirds of primary care providers (PCPs) see value in digital records (EHRs), but at the same time believe the technology has weakened relationships with patients, detracted from clinical effectiveness, and lack streamlined user experience. That deficiency is, in three words, lack of interoperability; that challenge has required one-half of physician-users to use work-around’s to make their EHR investments more useful. These insights come out of a survey conducted among primary care providers by The Harris Poll for Stanford Medicine, published to coincide with the medical school’s convening of the EHR

Half of U.S. patients were offered online access to their health records by providers or insurers, and one-half of them accessed the EHR at least once in the last year.  One in four of those offered online EHR access looked at them more than 3 times. It takes a good nudge from a provider to motivate a patient to access online medical records, found by ONC in their latest research into consumers’ use of EHRs detailed in Individuals’ use of online medical records and technology for health needs, the ONC Data Brief No. 40, published April 2018. he concept of

Two in five U.S. physicians feels burned out, according to the Medscape National Physician Burnout & Depression Report for 2018. This year, Medscape explicitly adds the condition of “depression” to its important study, and its title. In 2017, the Medscape report was about bias and burnout. Physicians involved in primary care specialties and critical care are especially at-risk for burnout, the study found. One in five OBGYNs experience both burnout and depression. Furthermore, there’s a big gender disparity when it comes to feeling burned out: nearly one-half of female physicians feel burnout compared with 38% of male doctors. Being employed by

Last week, President Trump once again used the “M” word (“murder”) in a sentence accusing the pharmaceutical industry of too-high priced products for U.S. health citizens. The sentence included the phrase, “Drug companies are getting away with murder.” That week, USA Today published an article on a new FDA-approved specialty drug therapy that could add up to over a $1 mm price tag. There is much to report in the world of pharmaceutical innovation, pricing, and patient Rx coverage this month. The CVS Health – Epic announcement ranks high in Health Populi’s vision for the evolving health/care ecosystem, bringing together two

It’s National Health IT Week (#NHIT Week), and I’m revisiting research published earlier this year to connect the dots between EHR implementation (good news: it’s nearly universal in doctors’ offices and hospitals) and patients embracing their health information (not-so-much). What’s missing: UX design and respect for peoples’ life-flows.  Most physician practices and hospitals in the U.S. have installed electronic health records (EHRs). But in a classic Field of Dreams scenario, we have made patients’ medical records digital, but people aren’t asking for them or accessing them en masse. “How do we make it easier for patients to request and manage their

Healthcare is at a digital inflection point, asserts   Internet Trends 2017 – Code Conference, by the iconic Mary Meeker of Kleiner Perkins. Published May 31, 2017, few tech-focused reports have the gravitas or generate the readership that this report does. I’m one of Meeker’s perennial readers, covering this report through my health/care lens here on Health Populi for several years (links to previous posts below). Of the report’s 355 pages, 22 are devoted to healthcare (pages 288-319), a section curated by Noah Kaufman of KP. This section of the report assembles data from a range of publicly available sources,

The autonomous car is a metaphor for healthcare: that’s how my first interview kicking off the  HIMSS marathon began. The annual 2017 HIMSS conference isn’t your father’s or mother’s HIMSS of ten years ago, or even the HIMSS of 2010 — the year that financial incentives for EHR adoption began to stream from the HITECH Act of 2009, motivating thousands of healthcare providers to acquire and meaningfully use digital health records systems. Then, the HIMSS conference floor was abuzz with EHR frenzy. This week, over 43,000 people working at the intersection of healthcare and technology have converged in Orlando, Florida, for

A special report on patient engagement and digital technology was published this month in the New England Journal of Medicine (NEJM). Based on a survey of doctors and healthcare executives, the research found that clinicians and managers welcome the opportunity to use digital tech — when it makes financial sense. That conclusion inspired the title of the article, Patient Engagement Survey: Technology Tools Gain Support – But Cost Is a Hurdle. NEJM polled 595 members of the NEJM Catalyst Insights Council, which included healthcare executives and clinicians who deliver healthcare. Here is NEJM’s scenario on patient-engaging health IT, a Holy Grail of sorts:

About 1 in 2 patients in the US are accessing their electronic health records in early 2016, according to Accenture’s 2016 Consumer Survey on Patient Engagement, Patients Want a Heavy Dose of Digital. This post is based on a presentation I attended by Accenture’s Dr. Kipp Webb yesterday. Accenture conducted survey research with consumers in seven countries for this study. The data and insights shared in this post are based only on the survey results from 2,225 US patients. The proportion of US health consumers accessing their health records grew from 27% in 2014 to 45% in 2016 — an increase of

Notwithstanding the head of the AMA recently referring to digital health technologies as “snake oil,” it appears that one-half of physicians is keen on digital health. And scale, not age, matters when it comes to doctors using digital health tools. The American Medical Association (AMA) surveyed physicians on their use of digital health tools, finding that primary care physicians (PCPs) and doctors working in larger and more complex practices tend to be more digital. In Physicians’ motivations and requirements for adopting digital clinical tools, the AMA’s digital health study, “Physicians are optimistic about digital health innovation and its game-changing potential

The number of hospitals offering patients electronic access to their health information grew seven times between 2013 and 2015. Electronic health records access has gone mainstream in America, according to the latest findings by The Office of the National Coordinator for Health Information Technology (ONC-HIT). The data are detailed in Electronic Capabilities for Patient Engagement among U.S. Non-Federal Acute Care Hospitals: 2012-2015, an ONC Data Brief. Two in three U.S. patients can now view, download, and transmit their personal health information, shown in the bar chart. This hockey-stick growth, from 10% in 2013 to 69% in 2015, results from the

Most Americans say accessing their lab tests, health history, prescription drug lists, and doctors’ notes is important. But patients in the U.S. do not universally have access to their electronic health information, and nor do all those who can access their personal health information do so, according to the Kaiser Health Tracking Poll: August 2016 from the Kaiser Family Foundation (KFF). In yesterday’s Health Populi blog, I focused on the Poll’s political findings — that Hillary Clinton is perceived by more American voters than Donald Trump to be trusted on health care issues. In today’s post, I’ll cover the poll’s findings on

A majority of U.S. hospitals could enable patients digital access to their personal medical records in 2015. Specifically, nearly all US hospitals offer patients the opportunity to view their medical records online in 2015. Eight in 10 hospitals were able to download patient information from their medical record as well as enable patients to request a change to that record, according to a Trendwatch report from the American Hospital Association (AHA), Individuals’ Ability to Electronically Access Their Hospital Medical Records, Perform Key Tasks is Growing. Over the past several years, hospitals have made significant capital investments in buying, adopting, and

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

The top health-related activities among U.S. adults include routinely taking vitamins and supplements, and prescription medicines, according to Frost & Sullivan’s report, Are We Engaged Yet? Their response to the titular question lies in in the subtitle: “US consumers appear confused or ambivalent about what it means to be proactive or engaged in their health.” 1 in 2 U.S. adults says they’re “somewhat engaged” in their healthcare, according to Reenita Das’s write-up on the study in Forbes magazine. She notes that: Consumers with higher incomes have more confidence in their access to health care services and quality of care Budget-constrained consumer

Cost ranks first among the factors of selecting health insurance for most Americans across the generations. As a result, most consumers are likely to shop around for both health providers and health plans, learned through a 2016 Xerox survey detailed in New Insights on Value-Based Care, Healthcare Attitudes 2016. The younger the consumer, the more important costs are, Xerox’s poll found, shown in the first chart. Thus, “shopping around” is more pronounced among younger health consumers — although a majority people who belong to Boomer and Greatest Generation cohorts do shop around for both health providers and health insurance plans —

  March 30 this week was National Doctors Day, which was proclaimed a national celebration by President George Bush in 1991. But as I’ve written through this week here on Health Populi, doctors may enjoy prestige on the outside, but they’re hurting on the inside — both economically in medical/business practices, and emotionally in their personal career-lives. Patients tend to like, even love, their personal physicians based on years of consumer polls on the topic (usually themed, “love my own doctor, hate the health care system”). But physicians and their patients aren’t on the same page, literally, when it comes

Patients are from Mars and Doctors from Venus when it comes to their views on whether consumers should have full access to their electronic health records (EHRs), according to a survey from Accenture released this week at the 2016 meeting of the HIMSS conference in Las Vegas. The vast majority of consumers are keen to access their full EHR, compared to a majority of doctors who advocate for limited access, as the circle diagram dramatically illustrates. The “old days” of patient information asymmetry — with a paper-based folder that got locked up in a health records cabinet — are gone.

Adoption of telehealth, remote health monitoring, patient engagement platforms, mobile and digital health applications, and the emergence of the Internet of Things in health care will all be bolstered in 2016 based on health care providers’ having to do more with less (money, labor, resources). The value-based healthcare world — the migration of payment “from volume to value” — requires greater investment in information and communications technology that moves care to lower-cost sites, with lower-priced labor (as appropriate), and shifting greater clinical self-care and financial skin-in-the-game to patients. My annual health IT forecast was published yesterday in iHealthBeat, 2016: Technology

The phone continues to be the platform technology used in this digital age of health care, according to Better Together: High Tech and High Touch, a survey report sponsored by the Bipartisan Policy Center and the Council of Accountable Physician Practices. Nielsen’s Strategy Health Perspectives project polled 5,014 U.S. adults in June and July 2015 for this study. According to the study sponsors, this is the largest consumer population studied conducted to-date on the topic of digital health use and demand. The first chart illustrates the reality of digital health in the U.S. 2015: that notwithstanding the availability of telehealth,

Retail health v1.0 encompassed the pharmacy, then embraced urgent care and retail health clinics co-located in brick-and-mortar pharmacy chain stores. In v2.0, retail health encompasses all health/care, really, because people, patients and consumers are essentially self-insured up to the point when their health plan kicks in some cash. The high-deductible health plan era is ushering in the retail health era, broadly writ. Hospitals & Health Networks magazine (HHN) ran a story titled Think Like a Retailer to Engage Patients, covering founder of WEGO Health Jack Barrette‘s and my panel presentation at the 2015 HIMSS conference in Chicago last week. Writer

They’re the team that built a brand with the phrase “Health 2.0” before the world barely recognized v 1.0 in healthcare. This week, those folks that brought you the Health 2.0 Conference unveiled the Market Intel database of over 3,000 companies, trying to make sense out of a very blurry and fast-morphing market landscape. I spoke with Matthew Holt and Kim Krueger of Health 2.0 earlier this week to discuss just what’s in this mine of information, and what they intend to do with it. In full disclosure, I have been a colleague and friend of Matthew Holt since his

Are you Feelin’ Groovy about wearables? Well slow down, you move too fast… …at least, according to Accenture’s latest survey into consumers’ perspectives on new technologies, published this week in conjunction with the 2015 Consumer Electronics Show in Las Vegas, the largest annual convention in the U.S. featuring technology for people. At #CES2015, we’re seeing a rich trove of blinged-out, multi-sensor, shiny new wearable things at the 2015 Consumer Electronics Show. Swarovski crystals are paired with Misfit Wearables, called the Swarovski Shine, shown here as a shiny new thing, indeed. Withings launched its Activite fitness tracking watch in new colors.

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,

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

A new conversation has begun between doctors and patients: talking about money and health care, and what treatments cost — specifically, what a particular treatment will cost a patient, out-of-pocket. Over a dozen physician professional societies are proponents of these discussions, and are providing support to doctors in their networks. Doctors already engaging in the topic of the cost of care with patients aren’t being altruistic about spending this precious time in the already-time-constrained patient encounter: these discussions are increasingly relevant to physicians’ financial outcomes. I’ll be addressing this new feature in the doctor’s office at the upcoming Point-of-Care conference,

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

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

People managing chronic diseases are more likely to have accessed information in their electronic medical records — and are also less likely to worry about the privacy risks of their personal electronic health information compared with people who are healthy. Over 2,000 people, both those who say they’re healthy and those with chronic conditions, were surveyed by Accenture in February-March 2014, and their responses are summarized in the report, Consumers with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion. Slight more consumers are concerned about privacy risks related to online banking, online shopping,

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

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

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

The rise of digital health at the 2014 Consumer Electronics Show signals the hockey-stick growth of consumer-facing health devices for fitness and, increasingly, more medical applications in the hands of people, patients, and caregivers. This year at #CES2014, while the 40% growth of the CES digital health footprint will get the headlines, the underlying story will go beyond wristbands and step-tracking generating data from an N of 1 to tools that generate data to bolster shared-decision making between people and the health system, and eventually support population health. For example: – Aetna is partnering with J&J to deploy their Care4Today

While about 53% of people globally are willing to share various types of personal data overall, the kind of data willing-to-be-shared varies by type of information — and what country we’re from. When asked how likely they would be to anonymously share information if it could lead to improvements or innovations in that technology, Americans are less likely to be willing to share any type of personal data — except for gender. When it comes to sharing several specific types of health information, fewer Americans are likely to want to share it as Intel found in their survey published in the company’s Healthcare

In health care, when money is tight, labor inputs like nurses and doctors stretched, and patients wanting to be treated like beloved Amazon consumers, what do you do? Why, innovate and thrive. This audacious Holy Grail was the topic for a panel II moderated today at the Connected Health Symposium, sponsored by Partners Heathcare, the Boston health system that includes Harvard’s hospitals and other blue chip health providers around the region. My panelists were 3 health ecosystem players who were not your typical discussants at this sort of meeting: none wore bow ties, and all were very entrepreneurial: Jeremy Delinsky

The FDA has spoken: there are 2 statutory definitions for a mobile health tool as a “medical device” that the Agency says it has regulatory oversight: To be used as an accessory to a regulated medical device, or To transform a mobile platform into a regulated medical device. On page 8 of the Guidance for Industry and Food and Drug Administration Staff, you can read the FDA’s expanded definition of a mobile health app as being: “…intended for use in performing a medical device function (i.e. for diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention

Mobilising Healthcare, a new report from Juniper Research, segments the mobile health sector into “healthcare” and “health & fitness” segments. The research summary notes that fitness is a relatively new market compared with health “care,” which has been around for eons. Fitness, the analysts say, “is exempt from government intervention.” Mobile healthcare (“mHealth”) applications explored include SMS health messaging, remote health provision such as cardiac monitoring, electronic health records and personal health records. In mFitness, Juniper looks into mobile tech for athletes and fitness conscious people, and activity tracking including heart function, distance, respiration, and perspiration, among other parameters. mHealth

1 in two people who are insured and have a regular doctor are interested in trying out an electronic medical record. But they need a doctor or nurse to suggest this, and they need it to be easy to use. The EMR Impact survey was conducted by Aeffect and 88 Brand Partners to assess 1,000 U.S. online consumers’ views on electronic medical records (EMRs): specifically, how do insured American adults (age 25 to 55 who have seen their regular physician in the past 3 years) view accessing their personal health information via EMRs? Among this population segment, 1 in 4 people (24%)

Today, October 4, Microsoft unveiled its long-awaited electronic health records system, Health Vault. In a white paper called Concepts of the Health Data Vault, the author discusses the value of an individual’s “health data bitstream.” The author goes on to say that, “The value of this bitstream is based on its organization and communication within an individual’s context. This value is not necessarily reflected in specific dollars and cents savings, but rather in the individual’s health, trust in the healthcare system, and community. It has the potential to radically shift the balance of power in today’s health care system.” This