A blog covering the health/care ecosystem and people.

At the ConvUrgent Care Symposium in Orlando, attendees from the worlds of clinics, ambulatory care, hospital beds, pharmacies, medical devices, life sciences, health information, health IT, health plans, academic medical centers and professional medical societies came together to share and learn about the morphing landscape of retail health. The topline message: primary care is everywhere, and based on the response to my keynote talk this morning, every stakeholder segment gets it. My mantra, courtesy of the U.S. Surgeon General Regina Benjamin: don’t look at health in isolation, that is, where the doctor and hospital are. Health happens wherever the person

It’s January and the #1 most popular post-New Year’s resolution is to lose weight, get fit, and live well. The signs of this are manifested in ads featuring Janet Jackson promoting Nutrisystem, Jennifer Hudson dueting with her then-and-now selves pitching Weight Watchers, as well as the new Weight Watchers for Men promotion starring Charles Barkley. But there are new signs that losing weight and getting fit are going beyond “diets” and food plans: research shows that moving around and getting exercise can help people sustain hard-earned weight loss more than just changing food intake and “dieting.” So the Apple store

As we approach 2012, we health prognosticators like to forecast what we’ll likely see in 2012. One of the for-certain trends will be the uptake of telehealth programs, which will be publicly, privately, and jointly-funded. The business case is clear for telehealth, both in the U.S. and globally. Jon Linkous, CEO of the American Telemedicine Association, told the mHealth Summit last week that, the “shift in the way healthcare is paid will put providers in driver’s seat when it comes to choosing the best way  to deliver healthcare and whether or not to use telemedicine.” The forces are converging for telehealth

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

Doctors won’t be celebrating Independence Day on July 4th — at least when it comes to their professional practices. The days of the cottage industry physician are dwindling as more doctors are losing their independence, instead opting for employment. There are several reasons for physicians’ exodus from private practice: these include increasing administrative burdens, economies of scale for adopting information and communications technology, security in uncertain futures around reimbursement, and that all-important work-life balance. Accenture points out these trends in a summary report, Clinical Transformation: Dramatic Changes as Physician Employment Grows.  Accenture sees benefits accruing to health systems acquiring physician

By 2050, the demand for long-term care (LTC) workers will more than double in the developed world, from Norway and New Zealand to Japan and the U.S. Aging populations with growing incidence of disabilities, looser family ties, and more women in the labor force are driving this reality. This is a multi-dimensional problem which requires looking beyond the issue of the simple aging demographic. Help Wanted? is an apt title for the report from The Organization of Economic Cooperation and Development (OECD), subtitled, “providing and paying for long-term care.” The report details the complex forces exacerbating the LTC carer shortage, focusing

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

Doctors practicing in the U.S. are becoming increasingly conscious of the increasing costs of health care. Most consider themselves cost-conscious, and are considering the impact of their practice patterns — in terms of prescribing medicines, tests, and procedures — on the nation’s health bill. In fact, most physicians feel they have a responsibility to bring down health costs. This perspective on physicians comes from the survey report, The new cost-conscious doctor: Changing America’s healthcare landscape, from Bain & Company, published in March 2011. Bain spoke with over 300 U.S. physicians to assess their perspectives on managing costs, drug and device usage, and

In the “House & Home” section of last weekend’s Financial Times, an article titled ‘Domestic Science’ talked about internet-operated vacuum cleaners that feed pets, refrigerators that track emptying cartons of milk, and the $10 Savant TruControl iPad app that helps control home systems’ remotely (tied to a $6,000 home-based system). The article also touched on the Withings WiFi body scale. The Withings scale communicates wirelessly to a computer or mobile phone, transferring and automatically recording the user’s weight, BMI, body fat percentage and other parameters to a secure, password-protected online system. The user can choose to tweet their weight via Twitter if they choose

There’s cameraphone hacking that morphs the phone into a blood test device. Embrace Labs in India builds an incubator for $25. Micro- mobile payments are financing health care on the ground in emerging economies.   At SXSW in Austin, TX, on March 12, 2011, a globally experienced quartet of panelists shared their observations of working with highly constrained budgets in developing countries during the session, Mobile Health in Africa: What Can We Learn? The answer is: plenty. Doug Naegele of Infield Health moderated the panel, which included Patricia Mechael of the Center for Global Health and Economic Development at the Earth Institute, part of Columbia University; Josh

“Employers and health insurers, through benefit design and medical management, are now playing a larger role in curbing use of healthcare services….spurring a more permanent cultural shift in consumer behavior,” Moody’s writes in a special comment dated February 16, 2011. “This will continue to constrain healthcare demand even as the economy recovers.” The chart illustrates one of the main reasons for the so-called “constrained healthcare demand:” increasing costs on health consumers. Look at the slope of the line on average out-of-pocket maximum costs for an employee receiving health insurance at work: the raw number grew from $2,742 in 2008 to

In February 2011, 1 in 10 jobs in the U.S. is in health care employment; nearly 14 million people in the U.S. work in health care employment, with health care representing 10.7% of all jobs in America. The growth rate of health care jobs rose 1.2 percentage points since the recession kicked in late 2007. Since the start of the recession, health employment grew 6.3%; the number of non-health jobs fell by 6.8%. The chart starkly illustrates this story. Altarum Institute has crunched the health job numbers from the Bureau of Labor Statistics (BLS) and published their analysis in Health Sector Economic Indicators, published

Mature users of electronic health records bear many scars and learnings, having been through the first several rungs of the health information technology (HIT) adoption ladder. A few of these lessons for HIT adoption success… Implementing EMRs is a strategic and not just an IT-department initiative. HIT adoption requires top-down commitment and engagement. It takes longer and costs more than the planners of systems expect. During transition to an EMR, hospitals see an 80% “spike” (increase) in IT operating expenses — directly impacting the hospital’s overall operating budget as much as 200 basis points or more. There is evidence that those spikes

Bet on it, live from Las Vegas at this week’s Consumer Electronics Show (CES): the new home health hub is digital, mobile and personal. More consumers are morphing TV and video watching from the “set” to the computer and mobile platforms, and DIYing more activities of daily living. Health (for both wellness and sickness care) is transforming in this process. This transformation is enabled through consumers’ adoption of technologies that they’re using in their daily lives for entertainment, household management, and communications. Broadband and wireless provide the infrastructure for health care to move beyond the doctor’s office and the hospital, so engaged patients who choose to do

It’s year-end, so the forecasts abound whether we’re talking about trends in technologies, products and services. Gartner says cloud and mobile computing are hot, but managing customer expectations will require heavy lifting  On the food front, Epicurious predicts that food halls will be all the rage (think Harrods in London or Takashimaya in Tokyo), Korean cuisine in demand, and sweet potatoes crowned the vegetable of 2011. For colors, Pantone is Queen and they see that honeysuckle (a salmon-pink) is the new black. In health technology, there’s no better list to read than CSC’s The Future of Healthcare: It’s Health, Then Care, which offers up top 10 technologies

The majority of Americans generally like the idea of remote home monitoring for health. 3 in 5 adults (62%) across all age groups say communication with doctors via home monitoring devices would improve their health. However, only 35% of people age 65 and over are interested in home health monitoring. Interest in remote home health monitoring decreases with age. The disconnect is that 90% of Americans age 65 and older have at least one chronic health condition, according to the Centers for Disease Control. Practice Fusion commissioned a survey from GfK Roper in November 2010 through the GfK Omnibus survey among 1,008 adults

“If more than 5 billion people in the world have access to mobile phones (not TVs or PCs), then content delivered to or accessed from mobile phones is the best mass media pick for sharing health information,” asserts a report released in November 2010 from MobiHealthNews, The Fastest Growing and Most Successful Health & Medical Apps. Overall, health and medical apps grew by 66%. However, growth rates by categories vary: medication adherence, still a small category, was the single fastest-growing category of iPhone health apps between February and August 2010 growing by 131%, followed by three areas with similarly high growth rates

With peoples’ adoption of mobile phones, broadband, and apps for which they pay out-of-pocket, the new person-centered medical home is…the home. Policy wonks can wax lyrically and econometrically spin models about how to bend the health cost curve. But patients are the most under-utilized resource in the U.S. health system, as Dr. Charles Safran testified to Congress in 2004. In 2010, patients are getting more engaged as they DIY more at-home: photograph development, travel planning, stock trades, and home improvement. So health care comes home. A column written by Dr. Steven Landers of the Cleveland Clinic, featured in the October 20th 2010 issue of

40% of U.S. consumers are willing to pay for remote health monitoring devices and services that would send their medical data to doctors, according to PricewaterhouseCoopers’ Healthcare Unwired (PwC). 51% of consumers would not buy mobile health technology. The uses of mobile health most attractive to consumers are monitoring fitness and welling (cited by 20% of consumers), physician monitoring of health conditions (for 18% of people), and monitoring a previous condition (for 11%). 88% of physicians would like to see patients monitoring various parameters at home, their highest priorities being weight (65%), blood sugar (61%), vital signs like blood pressure (57%),

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 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

The 30 most developed countries, on average, allocated 9% of their national budgets to health care in 2008, up from 7.8% in 2000. The U.S., in contrast, spent 16% of GDP on health care, nearly one-half of which came from public treasury coffers. The graph illustrates the statistics for each OECD member nation and the share of health care paid by public and private sectors. Note that the light-blue bar segment for the U.S. is a far larger proportion of the total bar compared to other countries: that’s the private sector’s contribution to health spending versus the dark blue, government

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

Three major consumer and health industry brand names are coming together to launch a telehealth home monitoring project: GE, Intel and the Mayo Clinic. Each organization has a deep bench and history in the health vertical, covering different segments of the market. With this project, 3 industry leaders partner to learn about home health monitoring’s challenges and opportunities in real-life, with real people. The project goal is to evaluate the effectiveness of daily in-home monitoring technology measured in 2 ways: reduced hospital admissions and reduced visits to the emergency room. For the project, Intel brings its Health Guide into the

It was the best of times, and the worst of times. Well, perhaps not the worst, but a time to pause and reflect on the power and the money. Thus I turn to a Tale of Two Cities.   As I depart Chicago and the 47th annual conference of the Healthcare Information and Management Systems Society, I recall two different meeting-experiences: the convention floor, with its mood of upbeat urgency, brightly colored booths and activity; and the education sessions and hallway conversations that featured pragmatic, real-world challenges.   ARRA, the American Recovery and Reinvestment Act of 2009, with its $19+

The buyers of medical devices aren’t very good shoppers: they lack the kind of information about technologies that would help them make value-based purchasing decisions. So says James Robinson in the November/December 2008 issue of Health Affairs in his essay, Value-Based Purchasing for Medical Devices.   This issue is so important because medical technology is the #1 factor driving up health spending in the U.S., according to the Center for Studying Health System Change in their recent report, High and Rising Health Care Costs: Demystifying U.S. Health Care Spending. What are medical devices? they’re the hardware used by surgeons and

Older Americans are healthier and more prosperous than previous generations. Furthermore, older people want to adopt technologies that will help them age well in their homes. Two new reports together provide a new look into aging in America. Older Americans 2008: Key Indicators of Well-Being is a wide-reaching data compendium which paints a current profile on aging in America through 38 measures that depict the well-being of older Americans. Measures include demographics, economics, health status, health risks and behaviors, and the cost and use of health services. The Chartbook is well worth reviewing to gain insights into this fast-growing population

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

I’ve been researching the topic of therapeutic hypothermia (TH) for cardiac arrest in the past couple of weeks on behalf of a client (we at THINK-Health work with the full range of stakeholders, which keeps our thinking fresh and the practice continually fascinating). So when Buffalo Bills player Kevin Everett received TH immediately following severe spinal cord injury on the football field, I closely followed his story. I have a dear cousin who became spinal cord injured due to a diving accident several years ago, and so the topic is of very personal interest to me. It is great news