Addressing chronic illness can help cure the U.S. budget deficit
Chronic illness represents $3 of every $4 of annual health spending in the U.S. That’s about $1.5 trillion. Living Well With Chronic Illness, a report from The Institute of Medicine (IOM), issues a “call for public health action” to address chronic illness through: – Adopting evidence-based interventions for disease prevention – Developing new public policies to promote better living with chronic disease – Building a comprehensive surveillance system that integrates quality of life measures, and – Enhancing collaboration among health ecosystem stakeholders: health care, health, and community non-healthcare services. The IOM recognizes the social determinants that shape peoples’ health status
The state of health IT in America: thinking about the Bipartisan Policy Center report on health IT
There are few issue areas within the Beltway of Washington, DC, that have enjoyed more support across the political aisle than health care information technology. In 2004, George Bush asserted that every American would/should have an electronic medical record by 2014. Since then, Democrats and Republicans alike have supported the broad concept of wiring the U.S. health information infrastructure. With the injection of ARRA stimulus funds earmarked in the HITECH Act to promote health providers’ adoption of electronic health records, we’re now on the road to Americans getting access to their health information electronically. It won’t be all or even
The Trust Deficit – what does it mean for health care?
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
Most Americans like the idea “Big Government” when it comes to food safety
Two-thirds of Americans favor increasing funding to the Food & Drug Administration (FDA) to ensure food safety in the U.S. Furthermore, 9 in 10 Americans also believe that the Federal government should be responsible for ensuring that food is safe to eat. And, 3 in 4 Americans say if it costs 1 to 3% more money to buy safer foods. they’d be willing to pay for those foods kept safer by the new food safety measures. A poll from the Pew Charitable Trusts, conducted by Hart Research Associates in April and May 2011, finds that when it comes to what Americans eat,
Verizon expanding into remote and mobile health for senior living – what it means for healthy aging and medical costs
The announcement that Verizon, the telecommunications giant, will partner with Healthsense, a home health monitoring company, indicates that the adoption of telehealth services beyond project pilots and government-funds required to bolster the market is real. Verizon is upgrading the FiOS network, which it will extend to senior housing and assisted living communities that would use Healthsense’s suite of remote health monitoring, personal emergency response systems, wireless nurse call, and wellness monitoring products. The broadband FiOS network is upgradeable to 100 megabits per second, which would enable the bandwidth required by home health technologies that require high performance and reliable network connectivity. These
Are health innovation and cost-reduction mutually exclusive? Insights from West Wireless’s Health Care Innovation Day DC
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
Consumer engagement with health IT isn’t about technology
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
The most engaged patients want “Social Media Liberación!”
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
Social networks and life science companies: balancing regulation and risk aversion with opportunity
One in 3 managers in life science companies — including biotech, pharma, medical device and diagnostics firms — have no plans to engage with online social networks, according to a survey conducted by Deloitte. The key reasons for shying away from social networks include lack of guidelines offered by the Food & Drug Administration (FDA), concerns about consumer privacy, and low or uncertain return on investment. On the other hand, 41% of life science execs already use social networks, and another 21% plan to do so. There are many benefits for life science companies in using online social networks, including using them for
The social life of pharmaceutical companies
Exactly one year ago, health care companies, online portals (from Google to health advocacy sites), and advertising agencies serving the health industry convened in Washington, DC, to voice their positions to the Food & Drug Administration (FDA) concerning pharmaceutical promotion and social media. It was such a monumental meeting that a tweetstream was initiated at the event that has been ongoing for the past year at #FDASM on Twitter. Why would hundreds of individuals collectively spend thousands of hours airing their arguments, pro and con, on the issue of how pharmaceutical companies promote their products and services online? “The drug industry
Another source of health care price/waste: the group purchasing organization?
Contrary to popular health economic wisdom, the group purchasing organization (GPO) raises costs for its constituents — hospitals — according to a study by two respected economists, Robert Litan and Hal Singer. Do Group Purchasing Organizations Achieve the Best Prices for Member Hospitals? An Empirical Analysis of Aftermarket Transactions found that hospitals could have saved, on average, 10 percent between 2001 through 2010 when they purchased medical devices aftermarket, when GPOs supposedly negotiated the best price; and, in 2010, the savings for hospitals was as much as 18 percent for purchases. The researchers analyzed 8,100 transactions from the MEMdata database. The authors recommend changing the incentive-payment
Can health IT transform the U.S. economy? The White House thinks so
The American Recovery and Reinvestment Act (ARRA, aka ‘stimulus funds’) is investing $100 billion worth of U.S. taxpayer dollars in projects meant to transform the American economy. $20-some billion of these funds are being earmarked for health information technology, which the White House sees as part of a “platform for private sector innovation” in a report published August 24 2010, The Recovery Act: Transforming the American Economy Through Innovation. Health IT (HIT) is bucketed with broadband and smart grid technology as planks in this economic-transformational platform. Among these three pillars, compare the $20 billion going to health IT with the $6.9 billion being
Mobile health and the FDA: what WellDoc’s approval means for mHealth
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
Running out money in retirement: the role of health costs
1 in 2 Baby Boomers born between 1948 and 1954 planning to retire in the first wave of Boomer retirements is at-risk of running out of money in retirement, according to the EBRI Retirement Readiness Rating. The Rating gauges just how prepared retirees are to finance their lives when they retire. This is defined as the percentage of pre-retirement households at-risk of not having enough money in retirement to pay for basic expenses such as housing, food, shelter, and uninsured health expenses. The net risk is determined as a function of retirement savings such as Social Security, IRAs, pensions, housing equity
Consumers trust pharma ads on TV more than online
Most consumers give thumbs-up to “fair and balanced” information on risks and benefits delivered in prescription drug ads on TV. But online? Not so much. This finding comes from one of the most highly anticipated surveys in the pharma business, the annual Prevention Magazine consumer survey on direct-to-consumer advertising (DTC). The FDA takes this survey seriously and its results inform FDA approaches to regulation. The 13th annual poll was published on July 15, 2010, titled, Consumer Reaction to DTC Advertising of Prescription Drugs. Most consumers find that “fair balance,” which is FDA required for presenting risks and benefits, is indeed “fair and balanced” on broadcast and in magazines. However,
Meaningful use: mandates, menus and morality
“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
On the Tiger Team and the insecurity of health information
Millions of health records for patients in the U.S. have been breached or compromised in the first half of 2010. Here’s a list derived from an ongoing search via Google News Alerts I monitor using the keywords, “health information and breach:” FedEx lost seven CDs of personal health information (PHI) from the Lincoln Medical and Mental Health Center in Bronx, NY, enroute to Siemens Medical Solutions, in March. This information affected 130,495 patients. The FAA believes that PHI for over 3 million U.S. pilots may be at-risk of breaching, according to a report published in June by the US Transportation Department. The FAA’s
The health supply chain will move closer to the patient
People responsible for managing the health care industry supply chain have always been concerned about regulations and compliance requirements that can negatively impact their ability to manage the materials, technologies, goods and services they need to fulfill their organizations’ medical missions and businesses. Now “health reform” joins regulation as a pain point in the supply chain. UPS, the logistics and transport company, has surveyed executives from pharma, biotech, medical and surgical device companies, to ascertain their current perspectives on the health care supply chain. The results of this study are in the report, UPS 2010 Pain in the (Supply) Chain
Employers are worried about health reform
A confounding, confusing regulatory regime after health reform kicks in
Good luck to stakeholders in navigating the health-regulatory labyrinth once health reform is implementing in the U.S. A report from PricewaterhouseCoopers (PwC) predicts, “A number of existing regulators will also have expanded roles as a result of the legislation.” These will be in addition to the new regulators identified by the law, which include but won’t be limited to: CMS Innovation Center Independent Payment Advisory Board Health Insurance Reform Implementation Fund Patient-Centered Outcomes Research Institute National Prevention, Health Promotion and Public Health Council Task Forces on Preventive Services and Community Preventive Services Community-based Collaborative Care Network Program Community Living Assistance
Health cost increases will hit double-digits in 2010 – another reason for real health reform
So much for America’s ability to manage health care costs without health reform: health costs will increase in the double-digits this year, according to Buck Consultants‘ 21st National Health Care Trend Survey. This annual survey monitors medical trend — the factors that drive cost increases. These include inflation, service utilization, technology, adding new programs, changes in service mix, and benefit mandates. The chart illustrates that medical trend varies across plans — but not my much. High-deductible consumer-driven health plans expect growth of 10.4%: hardly a significantly lower rate of growth than for the most open, rich plans (PPO, POS). Buck
What does a conservative shift in Americans mean for health reform?
Four in 10 Americans say they’ve become more conservative in the past 2 years. By a factor of 2:1, more Americans have turned more conservative versus more liberal. The shift for members of all three political parties has been to the right. This right-shift finding comes from the Gallup Poll of June 14-17, 2009, on annual trends in Americans’ political ideology. As of June 2009, 40% of Americans call themselves conservative compared to 37% in 2008. This is the highest level of self-described conservativism among Americans since 2004. Why might this mean for health reform in 2009?
Only 1 in 10 unemployed people buy into COBRA
Because of high premiums, only 9 percent of unemployed workers have COBRA coverage. Maintaining Health Insurance During a Recession: Likely COBRA Eligibility, a study from The Commonwealth Fund (CMWF), clarifies how COBRA is actually used by unemployed people in the U.S. CMWF calculates that: – Two of three working adults are eligible to buy into COBRA under the 1985 Consolidated Omnibus Budget Reconciliation Act (COBRA) if they became unemployed. – Under COBRA, workers pay 4 to 6 times their current premium for health benefits. – Thus, only 9 percent of unemployed workers have COBRA coverage due to the high price
Universal coverage and controlling costs – health priorities for President Obama
The most important elements of the economic stimulus package for health would be investing in health information technology, providing COBRA funding assistance for recently laid-off workers, and allowing unemployed Americans access to a public health insurance program. In the longer-run, getting to universal coverage while controlling costs and improving quality and efficiency should be the health care reform priorities for President Obama, according to 2 in 3 opinion leaders. These are the results of the 17th Commonwealth Fund/Modern Healthcare Health Care Opinoin Leaders Survey, conducted by Harris Interactive. The poll was conducted among 194 health care opinion leaders culled from
Affordable care and better information: what Americans want from a new-and-improved US health system
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
Market Justice vs. Social Justice in Health Care – Our National Identity Crisis
An outstanding commentary in this week’s Journal of the American Medical Association succinctly traces the history of U.S. health care in the context of “market justice.” Peter Budetti, MD, PhD, who teaches health policy at the University of Oklahoma, observes, “Fragmented and struggling to come to terms with externally imposed pressures, medicine is losing both its political force and moral compass.” Those so-called externally imposed pressures come from stakeholders behaving according to their own self-interest in the health market: employers, physicians, hospitals, suppliers, insurers, public officials, and of course, consumers. Dr. Budetti concludes that, “Market justice may have outlived its
Health Populi’s Tea Leaves for 2008
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
A new and improved FDA – for 3 cents more
A strong FDA is crucial for the health of our country. The benefits of a robust, progressive Agency are enormous; the risks of a debilitated, under-performing organizaiton are incalculable. These are the findings of the latest critical analysis of the Subcommittee on Science and Technology prepared for the FDA Science Board, FDA Science and Mission at Risk. FDA Commissioner von Eschenbach requested a hard look at the FDA one year ago, and this report is the sobering culmination of that effort. The Subcommittee included leading members of the scientific community familiar with emerging science, the external marketplace, and the
Health Care IT by way of Hollywood and Hip-Hop
The double-barreled news of Dennis Quaids’ twins receiving heparin doses 1,000x the prescribed dose while receiving medical treatment at Cedars-Sinai Medical Center, coupled with the tragic death of Kanye West’s mother following cosmetic surgery, focuses this health care paparazzi’s lens squarely on the role of information technology in health care. The Cedars-Sinai Chief Medical Officer has termed the Quaid event a “preventable error.” Donda West’s doctor has been described by the likes of People magazine and the Los Angeles Times as a clinician with at least 2 DUI’s and an assortment of malpractice suits — as well as a recommendation
Hammers, nails and health spending – regional variations in the U.S.
There is more money spent on health care for each citizen of Massachusetts and Pennsylvania than for a citizen in Utah, Arizona or Nevada. In fact, per capita health spending was 59% lower in Utah than Massachusetts in 2004. The latest state-by-state spending variations are highlighted in Health Affairs’ web-exclusive feature. Welcome to the statistical phenomenon in health care known as “regional variation.” The guru-researcher of regional variation is John Wennberg, who has detailed these trends in fhe Dartmouth Atlas. New regional health spending data were published in Health Affairs, which we health economists and policy wonks eagerly anticipate
I was invited to be a Judge for the upcoming CES 2025 Innovation Awards in the category of digital health and connected fitness. So grateful to be part of this annual effort to identify the best in consumer-facing health solutions for self-care, condition management, and family well-being. Thank you, CTA!
Thank you Team Roche for inviting me to brainstorm patients as health citizens, consumers, payers, and voters in the Healthcare Transformers series.
For the past 15 years, the annual CES conference in Las Vegas has been my go-to meeting for updating my research and network in digital health and consumer-facing electronics that people find meaningful for their well-being, families, and home lives. I'll be back in Vegas in January for a full week of Media Days, one-on-one meetings, and speaking about my perspectives on health consumers.