A blog covering the health/care ecosystem and people.

2 in 3 American adults use a broadband connection at home. Among those who don’t have high-speed access at home, most don’t go on the internet at home, and the others who do use dial-up connections (only 5% of adults). The Pew Internet & American Life Project knows more about Americans’ use of the internet than probably any other research organization, and their report, Home Broadband 2010, presents a comprehensive snapshot of how people in the U.S. are using the internet as of May 2010. The most striking statistic in Pew’s survey is that growth of broadband among African-Americans grew in double-digits

WellDoc received approval from the Food & Drug Administration (FDA) on August 2 2010 to market the company’s DiabetesManager system. This signals the regulator’s openness to mobile health solutions — a market moment that may usher in the new-and-improved era of personal health management. DiabetesManager uses the mobile phone as a platform for patients with Type 2 diabetes to gather, store and communicate personal health data such as blood glucose measurements; these data then feed into WellDoc’s algorithms that communicate personalized health coaching support back to patients in real-time. This process creates a closed-loop system that helps bolster patients’ decisions and behaviors throughout the day. Health

People trust the Internet “cloud” to manage many parts of their personal information, especially photos, e-mail correspondence, contacts, and videos. But personal health and financial information? Not so much. The chart illustrates that only 1 in 5 global citizens use the cloud to manage personal health information. KPMG‘s report, Consumers & Convergence IV,  highlights peoples’ feelings about privacy and security of their personal information, from vacation pictures to 401(k) statements. The verdict: most people trust of the cloud to store and share most kinds of their information except for their medical and financial information. Two-thirds of people globally use cloud computing applications,

People with cancer can successfully manage their pain and depression through telephone contact with health providers and home monitoring, demonstrated by a clinical trial conducted among 405 patients in Indiana. The randomized trial findings are published in the July 14, 2010, issue of JAMA in, Effect of Telecare Management on Pain and Depression in Patients With Cancer. In the study, the Indiana Cancer Pain and Depression (INCPAD) trial assessed patients with pain, depression, and both depression and pain. Pain and depression are the most common physical and psychological symptoms in cancer patients, according to an AHRQ Evidence Report/Technology Assessment. These symptoms go largely untreated

“We are only as good in treating patients as the information we have,” opined Dr. David Blumenthal, the national coordinator for health information technology in the Department of Health and Human Services, during yesterday’s launch of the new regulations on the meaningful use (MU) of health information technology. In the health care world, yesterday featured a star-studded line-up (live and via webcast) that ushered in the long-awaited meaningful use regulations that provide the roadmap for the adoption of electronic health records (EHRs) for providers, hospitals and doctors alike. Simultaneously, Dr. Blumenthal’s 4-page summary of the reg’s was featured in a tidy, useful article in the New

While 1 in 2 health CIOs say they’ll be prepared to apply for stimulus funding to adopt electronic health records in 2011, 80% are concerned about their ability to meet the requirements of meaningful use (MU). This lack of confidence on the road to MU is based on a host of challenges, from reporting requirements and lack of clarity of MU criteria to availability of IT talent and worries about access to capital. PricewaterhouseCoopers’ Health Research Institute (PwC) surveyed 120 health care CIOs and IT executives and published the detailed findings in the report, Ready or not: On the road to

While practice economics have always been the lifeblood for doctors’ businesses, this year, 7 of their top 10 challenges have to do with some aspect of finance: rising costs, uncertainty of Medicare reimbursement, managing compensation, negotiating payer contracts, and collecting payments from patients themselves. The other key hassle in 2010 for physicians is selecting and implementing an electronic health records system, #3 in the top-of-mind challenges for American doctors. The Medical Group Management Association, the advocacy group for physicians working in groups, published a survey this week conducted among its members in February and March 2010. Notice all the yellow shading in the chart?

While 8 in 10 Americans say that their physicians should have access to information contained in their electronic medical record, only 8% of people said an EMR is available to them but they don’t use it. Fully 37% of American adults are not sure their physicians even have an EMR, according to a HarrisInteractive/HealthDay survey on e-health records conducted in June 2010. As the chart indicates, health consumers aren’t very engaged with other aspects of information applications that may be available to them, from scheduling a doctor’s visit over the Internet to accessing the results of lab trests via email. As Humphrey

The Health 2.0 Conference convened its first meeting in Washington, DC, today, with public sector health leaders and private sector innovators coming together in a Great Big Kumbayah. This conference featured two prominent and key players absent from previous Health 2.0 Conferences: patients on every panel, and the  Federal government punctuating the start, the middle, and the end of the day’s agenda. The over-arching message: Data Liberación! says Todd Park, the DHHS Technology Officer. This follows last week’s launch by DHHS of the Community Health Data Initiative (which Park wants to rename with your help here). [More about the CHDI herefrom Health Populi] 

As we journey through the health IT “gold rush,” what do we know we know about health information technology that can help us smooth the ride? That’s the theme of the April 2010 issue of Health Affairs, and the issue offers a rich compendium of learnings. Two HIT David’s, Blumenthal and Brailer, dialogue about health IT policy in the larger context of health policy overall. Brailer points to ARRA’s health IT stimulus funding in the HITECH Act as one of the spectacular events in the history of health policy which changed the world of health information technology overnight. Dr. Blumenthal emphasizes

I’m in a country this week where 66% of health providers have adopted 9 of 14 critical electronic health applications, according to a study from The Commonwealth Fund. According to the same study, only 26% of U.S. providers have opted into these functions.    As I amble across cobblestoned and craggy streets, looking up to frescoe’d facades on 500 year old palazzi, church domes and the bluest sky ever, the signs of the Italian Renaissance are everywhere in walkable Florence, Italy.     But it’s not all art and architecture, gelato and chianti for me this week. It’s also the techno-reality

It’s been a year since the American Recovery and Reinvestment Act and the HITECH Act got the president’s signature. Since then, there have been countless meetings of standards-setters, CIO experts and medical informatics pros, all opining on the meaning of “meaningful use,” the criteria for certifying electronic health records and the vision for a Nationwide Health Information Network. As they asked in “Seasons of Love” from Rent, “525,600 minutes…how do you measure a year?” The chorus’s response: “In cups of coffee, in inches, in miles, in laughter, in strife.” And 525,000 journeys to plan. That’s about the number of physicians

In the coming months and years, I anticipate that Monster.com and other online job services will grow their revenues from the health industry. Three important studies this month confirm that, while health care eats up nearly one-fifth of the U.S. economy, there are shortages of professionals to fill two important jobs that are growing: primary care physicians (PCPs), nurses, and health information technology (HIT) workers. Let’s talk about the doctors, first. The Journal of the American Medical Association (JAMA) reports this week that doctors cut back their working hours since 1998 to 2008. At the same time, the second chart

The book Connected was recommended by my colleague, intellectual beacon and friend, Susannah Fox of the Pew Internet & American Life Project. In the midst of late nights analyzing health reform scenarios and medical microeconomics, I’ve made the time to read this book in its entirety. It’s been a worthwhile investment. Previously, the authors of Connected, Nicholas Christakis and James Fowler, found evidence on connectedness in health in the areas of obesity, smoking cessation, binge drinking, and other lifestyle behaviors that directly impact good or bad health.  This week, another team of innovative thinkers led by John Caccioppo from the

Economic challenges have forced 8 in 10 hospital CIOs to cut IT spending by about 10%. At the same time, these CIOs realize that penalties are looking in 2011 if they fail to implement “meaningful use” of EHRs. This is the Rock and a Hard Place PricewaterhouseCoopers (PwC) describes in the report of the same name.  PwC believes that the “stick” of Medicare payment penalties will be more compelling than the “carrot” of HIT incentives provided by the HITECH funding: based on the firm’s calculations on modeling the funding for providers, the report asserts that, “the stimulus funding for health

“We believe America can have high quality, affordable and accessible health care by 2012.” Who said that? If you guessed President Obama, Senator Edward Kennedy, or Hillary Clinton, you’re wrong. It’s Wal-Mart, on its Health and Wellness webpage. Wal-Mart’s got a new direct-to-physician strategy: selling electronic health records (EHRs). The world’s largest retailer, #1 on the Fortune 100, expands on the company’s experience with retail health clinics. The chain now has 30 clinics sprinkled throughout the south, and in each clinic, there’s an EHR system. The EHRs will be offered through Wal-Mart’s subsidiary, Sam’s Club, jointly with Dell and eClinicalWorks,

Anxiety about health care costs tops American citizens’ concerns about health care in the U.S. Rich, poor, insured or un-, 2 in 3 Americans worry about the affordability of health care in America.   So it follows, then, that among those without health insurance, 57% blame their uninsured state on the fact that they simply cannot afford it, as shown in the table on the right. Beyond this group, 30% of the uninsured cite the employer’s role in health insurance: 14% aren’t employed, 9% have employers who don’t offer coverage, and 7% are “between jobs.”   These findings come from

Consumers, at least Californians, do a lot of looking for health information on the Internet — but very little health management.   California HealthCare Foundation (CHCF) has taken a snapshot of Californians’ use of the Internet in health care. The profile is presented in CHCF’s report, Just Looking: Consumer Use of the Internet to Manage Care.   Topline: insured, more affluent, and younger people use the Internet in health searching.   The most popular care-related uses on the Internet include searching for information about conditions and drugs, finding a physician, checking ratings, and looking for claims and benefit information online.

On this eve of the annual meeting of the Healthcare Information and Management Systems Society (HIMSS) in Orlando, I’m meditating and getting myself prepared for the next three days at the Orange County Convention Center. Why? Medicare. Last week, President Bush has already announced a budget cutting hospital funding for fiscal year 2008. The President proposes cuts in Medicare and Medicaid spending by $196 billion over five years, with hospitals in the bulls’-eye of the reductions. Hospitals are a primary target audience attending HIMSS. HIMSS is akin to a shopping mall with stores featuring every conceivable aspect of health IT:

I “leave” you for the year with some great, good, and less-than-sanguine expectations for health care in 2008. These are views filtered through my lens on the health care world: the new consumer, health information technology, globalization, politics, and health economics.  Health politics shares the stage with Iraq. Health care is second only to Iraq as the issue that Americans most want the 2008 presidential candidates to talk about, according to the latest Kaiser Health Tracking Poll. Several candidates have responded to the public’s interest with significant health care reform proposals. But major health reform – such as universal access