A blog covering the health/care ecosystem and people.

Transparency and authenticity, constant and clear communication, and a drive toward value underpin the future health system — for those health leaders who can commit to these pillars of transformational change. Leading Through Transformation: Top Healthcare CEOs’ Perspectives on the Future of Healthcare summarizes the interaction among 17 health execs who convened at the second CEO Forum held by Huron Healthcare Group. The report was released in January 2012. Health leaders concur that regardless of the politics of the Affordable Care Act and its prospects for whole or partial survival beyond November 2012, market pressures in the health sector are driving

She’s likely to be female, Facebooking, smartphoning, and digitally shopping. She’s the Connected Consumer, and she’s a lot older than you might expect: on average, 40 years of age, and with a mean household income of $63,000. And Connected she is: in addition to having a PC or laptop computer, 43% have a smartphone, and 16%, a tablet. Meet the Connected Consumer is a report from Zmags, a digital design company. Zmags surveyed 1,500 U.S. adults in November 2012 who owned a tablet, a smartphone and/or a computer, asking people their views on shopping, apps and the digital lifestyle. Connected

Technology, autos, food and consumer products — two-thirds of people around the globe trust these four industries the most. The least trusted sectors are media, banks and financial services. Welcome to the twelfth annual poll of the 2012 Edelman Trust Barometer, gauging global citizens’ perspectives on institutions and their trustworthiness. This survey marks the largest decline in trust in government in the 12 years the Barometer has polled peoples’ views. Interestingly, trust in government among US citizens stayed stable. The top-line finds a huge drop in global citizens’ trust in government, with a smaller decline for business. There’s an interplay

    Health Populi’s Hot Points: Please stop censorship in the United States of America. Click on this hyperlink to easily contact your Congressional representatives and express your opinion on SOPA and PIPA – two laws that would limit basic freedom in the marketplace of ideas and commerce.

The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9%  in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts.   Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which

‘Tis the season of weight loss plans, particularly among women, as this NPR story discusses. For the weight loss industry, this first quarter of the new year is akin to Black Friday for retailers the day-after-Thanksgiving. Special K called January 2, 2012, as National Weigh-In Day. To commemorate the event, Kelloggs commissioned a survey among women to find out what “inspires and tires” them when it comes to losing weight. Two-thirds of women in the U.S. started or re-started a weight management plan on January 1st, 2012. Other times of the year when women initiate weight-loss plans are to prep

Over 20% of U.S. families had problems paying medical bills in 2010 — about the same proportion as in 2007. The Center for Studying Health System Change found this datapoint “surprising,” given the Great Recession of 2008 that lingers into 2012. However, HSC points out that the leveling of medical bill problems may be a “byproduct” of reduced medical care utilization; in Health Populi-speak, self-rationing of health care. In the Tracking Report, Medical Bill Problems Steady for U.S. Families, 2007-2010, HSC analyzed data from the 2010 Health Tracking Household Survey and discovered that since 2003, the proportion of families facing problems with medical debt

The market for health and wellness has traditionally included over-the-counter medicines, gym memberships, and vitamins/minerals/supplements. In 2012, the boundaries of health/wellness are blurring beyond these line items toward preventive medical services and consumer electronics. This morphing market is discussed by Cambridge Consultants in their report on the disruptions driving The Business of Health & Wellness: Engaging consumers and making money. Cambridge correctly introduces this analysis by saying that economics, the growing prevalence of chronic diseases, an aging population, and demand consumers are shaping health/wellness, “recharacterizing” the market as one driven by “life events.” Cambridge sees that health consumers are changing their spending

The percentage of U.S. adults seeking health information declined from 2007 to 2010, according to the Health Tracking Household Study conducted by the Center for Studying Health System Change (HSC), published in November 2011. In 2007, 57% of consumers sought health information, falling to 50% in 2010, HSC found. The chart illustrates where the big drop in health information seeking occurred: in print media including books, magazines and newspapers, falling by one-half from 33% of consumers to 18%. The Internet (with 33% of consumers searching health information online) and friends and family (attracting 29% of consumers) remained relatively flat as information sources. TV/radio dropped 5.6 percentage

The Great American Recession of 2008 will reawaken in 2012, Goldman Sachs expects. In the current economic climate of a jobless recovery and dropping home values, the definition of The American Dream has changed. It’s more about personal fulfillment than financial gain, according to the 2011 MetLife Study of The American Dream: The Do-It-Yourself Dream. This is the rise of the “do-it-yourself” American Dream, MetLife found in its survey of 2,420 online adults conducted in September-October 2011. Across the generations — from Silent (born between 1920 and 1945) to Gen Y (born between 1978 and 1993), this redefining concept is relatively consistent.

The Internet, broadband, mobile health platforms, and consumers’ demand for more convenient health care services are fueling the development and adoption of health technologies in peoples’ homes. However, designing products that people will delight in using is based on incorporating human factors in design. Human factors are part of engineering science and account for the people using the device, the equipment being used, and the tasks the people are undertaking. The model illustrates these three interactive factors, along with the outer rings of environments: health policy, community, social, and physical. Getting these aspects right in the design of health technologies meant for

Per capita calorie intake has grown by 9 to 30 calories a day since the 1980s. Portion sizes have grown; as a result, so has the level of overweight and obesity in America. By 2020, 83% of men will be overweight or obese in the U.S.; so will 72% of U.S. women, according to Mark Huffman in a paper presented to the American Heart Association meeting in November 2011. “An individual’s decision to eat is not a result of personal weakness, but rather is determined, to a great extent, by the many environmental cues that have emerged since the early

There is broad consensus among doctors, patients and health administrators that the current U.S. health system is broken and unsustainable; preventive services is under-utilized and -valued, quality is highly variable from region to region and patient to patient, and costs continue to spiral upward without demonstrating value. While these 3 segments – physicians, people-patient-consumers, and hospital execs, agree on this topline assessment, what they see about the future of health delivery in America varies, according to a new survey from the new Optum Institute for Sustainable Health, Sustainable health communities: A manifesto for improvement. This is the kick-off of the Optum Institute, a member of the

Health philanthropies are about more than making grants. The Robert Wood Johnson Association, among the largest health philanthropic organizations in the world, is partnering with the Federal Reserve Bank (the Fed) on how community development impacts health — and vice versa. You cannot have a healthy community without focusing on housing, schools, and other neighborhood stakeholders, Dr. Risa Lavizzo-Mourey told the conference on Healthy Communities: Building Systems to Integrate Community Development and Health. In this context, Dr. Lavizzo-Mourey quoted Robert Kennedy who said, “The gross national product does not allow for the health of our children, the quality of their education, or

The growth in prescription drug costs covered by employers and Rx plan sponsors are driving them to adopt a long list of utilization management and price-tiering strategies looking to 2012, according to the 2011-2012 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals. The average drug trend for 2011 — that is, the average annual percentage increase in drug cost spending — was 5.5%, 1.5 percentage points greater than general price inflation of about 4%. The generic fill rate was 73% of prescription drugs purchased at retail. While drug price inflation is expected to increase in 2012, plan

More people with higher levels of concern about their health feel they are in good health, see their doctors regularly for check-ups, take prescription meds “exactly” as instructed, feel they eat right, and prefer lifestyle changes over using medicines. And 40% of these highly-health-concerned people have also used a health technology in the past year. At the other end of the spectrum are people with low levels of health concern: few see the doctor regularly for check-ups, less than one-half take their meds as prescribed by their doctors, only 31% feel they eat right, and only 36% feel they’re in

Walmart is increasing premium sharing costs for employees subscribing to health insurance, and cutting the benefit for part-timers. Quoted in the New York Times, a company rep said, “over the last few years, we’ve all seen our health care rates increase and it’s probably not a surprise that this year will be no different. We made the difficult decision to raise rates that will affect our associates’ medical costs.” In so doing, Walmart told the Times that they will, “strike a balance between managing costs and providing quality care and coverage.” MarketWatch wrote that Walmart will increase health care premium costs

Two publications this week reinforce the new reality of health and financial insecurity: The Vanishing Middle America issue of Advertising Age (October 17, 2011 issue) and the Sun Life Financial U.S. Unretirement Index – Fall 2011 with the subtitle, “Americans’ trust in retirement reaches a tipping point.” The chart shows the retirement coin’s two sides: since 2008, the proportion of people in the U.S. who expect to retire by 67 dropped from 52% down to 35%; and, those who believe they will be working full-time (I emphasize “full,” not “part,” time) grew from 19% to 29%. 61% of working Americans plan to

The passage of health reform in the U.S. has not enhanced peoples’ confidence in the American health system. In fact, U.S. health consumers’ high confidence level in the future of employer-sponsored health benefits has eroded over the past ten years, according to the Employee Benefit Research Institute‘s (EBRI) 2011 Health Confidence Survey: Most Americans Unfamiliar with Key Aspect of Health Reform. Most people are dissatisfied with the U.S. health system overall, with 27% of U.S. adults rating the system as “poor” and 29% giving a rating of “fair.” High costs may be at the root of peoples’ dissatisfaction with the U.S. health

While women may equally ‘value’ healthy aging in the long-run, it’s their daily quality of life that may motivate them to stick with exercise routines. Simply put, immediate payoffs are more motivating to sustaining behavior change than the long-term promise of “health.” In Rebranding exercise: closing the gap between values and behavior, Michelle Segar and colleagues from the University of Michigan (disclosure: my beloved alma mater) describe the state of women and chronic illness, and the difficulty in sustaining physical activity especially in middle age. “While a number of interventions can help individuals successfully initiate an exercise program, most interventions have failed

3 in 4 of the Fortune 50 companies are part of the U.S. health economy in some way. Only 1 in 3 of these is in traditional health industries like pharmaceutical and life science companies, insurance, and businesses in the Old School Health Care value chain. 2 in 3 of the Fortune 50 companies involved in health are in new-new segments. In their report, The New Gold Rush, PricewaterhouseCoopers (PwC) identifies four roles for “prospectors” in the new health economy which will represent 20% of the GDP by 2019: Fixers Connectors Retailers, and Implementers. These are the disruptive roles that will

“Value” in prescription drugs is first and foremost about outcomes, in the eyes of physicians and biopharma. For managed care, “value” is first about safety, then patient outcomes. However, although one-third of patients managing a chronic condition cannot define “value” in health care, 9 in 10 say that prescription drugs are “valuable” to their health and wellbeing. In fact, 80% say that the money they spend on prescription medications is “worth it.” Yet patients feel largely out of the prescription drug development process. These findings come from Quintiles research report, The 2011 New Health Report, subtitled: exploring perceptions of value and collaborative relationships among

Randomized controlled trials (RCTs) have been the rational cornerstone of medical decision making for decades. RCTs demonstrate a drug or therapeutic course’s efficacy – that is, the extent to which a specific intervention, procedure, or regimen produces a beneficial result under ideal conditions. Of course, how a particular therapy works in an individual is highly personalized based not only on a body’s biochemistry, but personal preferences, perceptions, and personality. That’s why Dr. Andrew Weil and his colleagues, Dr. Scott Shannon and Dr. Bonnie Kaplan, say that medical decision making should take into account the patient perspective. In Medical Decision Making in

Health professionals are go-to sources for medical diagnoses, information about prescription drugs and alternative treatments, and recommendations for doctors and hospitals. On the other hand, health information seekers turn to fellow patients, friends and family for emotional support in dealing with health issues, and quick remedies for everyday issues. And increasingly, those health information searches are going mobile, with 17% of U.S. adults having ever used their cell phone to look up health or medical information. This proportion nearly doubles for 18-29 year olds, and is also higher for wealthier people, Latino’s, college graduates, and urbanites. 1 in 10 people with a

Apple has supplanted Google as the world’s #1 most valuable brand, worth more brand-wise than Microsoft and Coca-Cola combined (#5 and #6). the other most valuable global brands are IBM, McDonalds, AT&T, Marlboro, China Mobile, and GE. Technology brands have significantly grown in value with consumers allocating more personal disposable income to products like tablet computers and smartphones, even in the face of recessionary economics the world over. Technology companies are now 1/3 of the top 100 brands. Millward Brown, the brand consultancy that is part of WPP, the global communications firm, has conducted the BrandZ top 100 most valuable

Two mega-trends are driving down branded pharmaceutical sales in the U.S.: switches from branded to generic prescription drug products for major chronic conditions; and, the lack of new-new branded Rx products that (could) command higher prices. A down-market picture emerges from The Use of Medicines in the United States: Review of 2010, based on market data analyzed by the IMS Institute for Healthcare Informatics (IMS). While U.S. market growth for pharma overall ranges from 3% to 5%, IMS says, protected Rx brands were negatively impacted through the switch to cheaper generic substitutes. Generics now comprise 78% of pharma market share. The key sentence

Representatives from eight U.S. Federal government agencies, including the FDA and Veterans Administration, among others; health financiers (VCs, angels); health tech start-ups; providers, life science companies, and analysts, attended the Health Care Innovation Day DC sponsored by West Wireless Health Institute on April 28, 2011. The meeting had the tagline, A Discussion with the FDA, setting the stage for a day-long consideration of the role of regulation vis-a-vis health innovation. The $2.5+ trillion question (annual spending on health care in the U.S.) is: can innovation drive making health care “cheaper?” This was the underlying theme of the panel on which I sat

Today’s kickoff of the National eHealth Collaborative‘s Consumer Consortium on eHealth convened the most diverse workgroup of over 70 stakeholders with various lenses on consumers and health, rarely seen at similar meetings, as Lygeia Ricciardi (@lygeia) of the Office of the National Coordiantor for Health IT (ONC) in the Department of Health and Human Services, observed. However, although representing every conceivable segment of health consumer stakeholders, from seniors (AARP)  and physicians (MGMA) to people with disabilities (AAPD), women (National Partnership for Women and Families) and people who fall through the health safety net (the National Health IT Collaborative for the Underserved), there was concurrence

Anyone attending a Health 2.0 or health IT meeting in the past 18 months has (hopefully) been exposed to the force known as  Todd Park, Chief Technology Officer of the Department of Health and Human Services, and his mantra of “Data Liberación.” Data Liberación is the act of freeing data — in this instance, health data — locked within data silos, to be ‘liberated” allowing it to move about so that analysts can learn from it and develop strategies to better manage health for individuals and populations. Now there’s a force advocating for “Social Media Liberación” in Health: health activists, the most engaged patients

Unique visits to online health sites continue to grow as a proportion of total unique visitors to the Internet, based on comScore’s research of web activity from January 2010 to January 2011. comScore published its Fifth Annual Online Marketing Effectiveness Benchmarks for the Pharmaceutical Industry in March 2011 based on a one million person U.S. panel coupled with 77 studies into specific pharmaceutical cases. The growth in people using online health resources is an opportunity for health marketers — in this case, pharmaceutical drug marketers — to reach potential patients and develop more effective education campaigns that are unbranded (to provide information

In the pharmacy market battle between Davids and the Goliath, David wins in the latest Consumer Reports survey on best drugstores according to consumers: independent pharmacies come out on top, and Walmart ranks last on the roster. The most highly-rated chains, highly indexed at 90 or more points, Health-Mart, The Medicine Shoppe, Bi-Mart, Publix, Hy-Vee, and Wegmans. Target, which was just ranked the #1 retailer in brand equity by the Harris Poll (where Target also beats Walmart in general retailing brand equity), ranked lower with an 88: much higher than Walmart with a 78 index, but below Walmart’s Sam’s Club and several grocery

“The tipping point for smartphones is now,” claims BabyCenter, the mom-focused internet portal. Mothers are 18% more likely to have a smartphone than the average person, according to the 2011 Mobile Mom Report, a survey from BabyCenter. Why do moms like smartphones? According to BabyCenter, the smartphone is a mom’s “helping hand.” Nearly 1 in 2 say the smartphone helps them decrease stress, and 1 in 4 say it gives them a sense of calm. So is the smartphone in itself a health-promoting device? For readers of Health Populi, the answer is “yes” based on this poll. In the past

Most U.S. health consumers would be keen to take advantage of alternative communications for their health care encounters. Of these 6 in 10 people, 72% would like nurse helplines, 60% email, and 1 in 3 would use a private online forum for their health. However, only 1 in 10 would use some form of social media for interacting with their providers, such as Facebook or Twitter, were it available to them in February 2011. Capstrat surveyed U.S. adults to learn about their perceptions and interactions with the health system. At least one-half of health consumers would use electronically-accessible applications offered by

Consumers have  been shell-shocked with health care costs — an increasing proportion of household spending in the U.S. This is true for the increasing costs consumers bear in the traditional health system. However, consumers are continuing to spend discretionary income on non-traditional health services such as complementary and alternative medicine (CAM) providers and products, along with vitamins/minerals/supplements and weight loss regimes. With increasing health cost burdens on households, those householders have less money to allocate to other aspects of life. In particular, growing medical costs have translated into greater credit problems for American consumers, according to The hidden costs of

As we are in the midst of the Hype Cycle for mHealth, the answer to the question, Health – is there really an app for that? has a loaded answer. This will be evident during the panel on which I’m participating on Sunday 3/13/11, the first full day of health hosted as part of the legendary South by Southwest conference. I am absolutely gob-smacked thrilled to be sharing the stage with John DeSouza, President and CEO of MedHelp; BJ Fogg of the Stanford Persuasive Technology Lab; and, Margie Morris, clinical psychologist and senior researcher at Intel Labs. We’ll be shepherded by Gigi Peterkin of Edelman, who

Patients like the idea of advanced health IT, while continuing to be concerned about the safety and security of their personal health data. Dell polled patients and hospital executives on their opinions of health reform, technology, and other health care topics, reported out in The Dell Executive & Patient Survey. Overwhelming majorities of consumers are inerested in: Electronic access to information about a hospital to help determine which hospital to visit (81%) Electronic prescription processing (76%) Making it possible for EHRs to be shared between physicians, hospitals, and ancillary providers (74%) Providing more information electronically such as follow-up care post-discharge (73%)

Most health consumers in the U.S. use the internet to seek health information, socialization and empowerment. Dig deeper, and you’ll find a growing cadre of people who go online to find people with the same conditions they have; 1 in 4 people (23%) among those living with chronic conditions have gone online to ID others like them, including people with high blood pressure, diabetes, heart disease, lung conditions, cancer, and other chronic health issues. The percentage of people looking for “people like me” drops to 15% of internet users with no chronic conditions seeking health-peers online. However, peers-in-health aren’t always seen as the ideal source

“I’m not a class warrior. I’m a class worrier,” Robert Reich told a standing-room only crowd of thousands of health IT geeks as he delivered the first keynote address of the annual meeting of HIMSS, the Healthcare Information Management and Systems Society. This year’s crowd will have reached about 31,000 people interested in health information technology’s transformative role in health care. The 31K represents an 18% increase in attendance from last year’s crowd. The HIMSS economy is strong. Robert Reich warns, however, that the U.S. macroeconomy is far from healthy…and health care costs will be a long-term threat to the

What doctors are most likely to use patients’ personal electronic health records? Fewer than 1 in 2 are willing to. Those who most likely would include Hispanic physicians, doctors who practice in rural areas, those employed in hospitals, and surgeons. As part of the HITECH Act included in the American Recovery and Reinvestment Act (ARRA) 0f 2009, U.S. physicians have the opportunity to receive a portion of the $20.8 billion carved out as incentive payments to those who adopt and “meaningfully use” electronic health records (EHRs). Many EHRs include portals which allow patients to access a slice of their personal health information.

We technology market data junkies look to several thought leaders throughout the year for updates on their forecasts: one of these, for me, is Mary Meeker. Now with KPCB (who some of you know as Kleiner Perkins Caulfield & Myers, the Silicon Valley venture capital company), Meeker has surveyed the morphing field of mobile and finalized her snapshot in Top Mobile Internet Trends, along with her colleague Matt Murphy.  Meeker’s Top 10 (drum roll, please) are that: 1. Mobile platforms have reached c4itical mass 2. Mobile is global 3. Social networking is accelerating growth of mobile 4. Time shifting is driving mobile use

Women’s #1 priority is health and wellness. Wellness means taking care of herself, based on a survey of women by Saatchi Wellness.  Women are coming out of the recession with the modus operandi of a “me-covery,” according to Saatchi Wellness’s read on women’s attitudes about the economy’s impact on their wellbeing and health priorities among 800 women polled online in August 2010. The 5 elements of the “me-covery” for women are: To eat right. This doesn’t mean “diet;” it’s striking a balance and buying healthier, and more organic, food. People most negatively impacted by the economy are buying less fast food. To

While 8 in 10 U.S. adult internet users seek health information online, they’re not the people you might assume would take advantage of the opportunity to do so. This lightbulb moment is brought to you by the Pew Internet & American Life Project’s latest survey analysis,  Health Topics: 80% of internet users look for health information online. For example, while 2 in 3 U.S. adults with one or more chronic condition go online, only one-half of them are looking online for health information. Among the 54% of online adults with disabilities, only 42% of them seek health information online. Among the 88%

While 8 in 10 U.S. adults want a physician to have primary responsibility for the diagnosis and management of their health care, many people are not sure who’s a medical doctor. Surprisingly numbers of health consumers don’t think that orthopaedic surgeons, family practitioners, dermatologists, psychiatrists, and ophthalmologists are MDs. The American Medical Association‘s survey, Truth in Advertising, published in January 2011, follows up the AMA’s 2008 survey which had similar results.  Data based on consumers answering the question, “Is this person a medical doctor,” are organized in the chart. 90% of people say that a physician’s additional years of medical education

An Explanation of Benefits (EOB) came in the U.S. mail yesterday. A plain piece of white 8.5″ x 11″ printed in tiny font with black ink, the logo of my health insurance company in the upper left of the form, and several lines of words and numbers showing me names of providers and facilities, dollar amounts billed, dollar amounts discounted, dollar amounts paid to the providers, and dollar amounts that were the patient’s responsibility — that would be me. The procedure was for a colonoscopy, for preventive screening and base lining for future reference. The good news: my colon looks just fine, and I’ll be reminded

If you don’t speak French and/or have aging eyesight, you might not understand the label on the medicine in the photo. When someone doesn’t understand the label placed on their prescription drug, they’re in a compromising position: this lowers health literacy and potentially endangers peoples’ health. As I monitor the tweets from today’s meeting of the Business Development Institute’s (BDI) Mobile Healthcare Communications conference, covering statistics and case studies about who’s using smartphones for accessing health information and how pharmaceutical companies can bolster adherence by developing mobile health apps, I’m struck by an important story in the health news that won’t get much coverage because it’s not about

‘Tis the season…perhaps, era…for scenario planning in health. The activity consumes a lot of my consulting time these days for stakeholders falling under the broad umbrella of “health.” With the news that Sam’s Club will offer health care for $99 out-of-consumers’ pockets, it got me wondering…where might Walmart be in the health care ecosystem in a few years, say 2015? Sam’s Club launched The Prevention Plan in January 2010, with a partner, U.S. Preventive Medicine. The “Plan” isn’t a health plan, per se; it’s a year-long subscription that gets the user some coaching for managing health risks. Step 1 is a blood

Caregivers identify the most helpful technologies that benefit them in providing care to family and friends as personal health record tracking, medication support, caregiving coordination, and monitoring and transmitting symptoms. These technologies are seen to help caregivers save time, make caregiving logistically easier, make the care recipient feel safer, reduce stress and enhance feelings of being effective. The most formidable obstacle preventing caregivers from adopting beneficial technologies is cost, followed by the technology not addressing the caregiver’s most pressing challenges, care recipient resistance to using the device, privacy issues, diminishing the care recipient’s sense of independence and pride. The National Alliance

1 in 2 people who use the internet to seek health information do so to self-diagnose; this is highest in China, US, UK, Russia, and Australia. Furthermore, health citizens in emerging economies including India, Russia, China, Brazil, and Mexico, may rely more on online health searches than people in developed countries. In these regions, health seekers face high costs of face-to-face visits with medical professionals. These global findings come out of the report, Online Health: Untangling the Web, from Bupa. Bupa is a health company based in the UK that serves 10 million members in 190 countries, and another 20 million

The one issue in health politics that’s got bipartisan support is health care IT. While Republicans in the House may try to pick away parts of the Affordable Care Act, the HITECH Act — part of the 2009 stimulus package formally known as the American Recovery and Reinvestment Act — will stay intact, according to most industry analysts (including me). However, political agreement doesn’t equal market adoption. So forecasting what 2011 will mean for health information technology requires some deeper analysis of additional issues. For today’s Health Populi, take a look at my annual health IT forecast in California HealthCare Foundation‘s