Innovation Conference in Boston
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by Tony Chen
I'll be at PDMA's "Front End of Innovation" Conference in Boston next week. If anyone is around and up for drinks, let me know.
Last time I checked, I couldn't find any other hospital members of the PDMA (Product Development and Management Association). Think of them as the ACHE for innovation & product development people. As I interact with this group, I'm definitely stretched by their progressive thinking about how to bring innovation into any culture/organization (apparently, the Russians did a lot of innovation theory work back in the day that are still being utilized widely today).
What can hospita...
Source: hospital impact - May 16, 2008 Authors: hospitaltony
Boomers confront the economic downturn
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The economic downturn has led to personal cutbacks on medications and funding retirement savings, according to the AARP's survey on The Economic Slowdown's Impact on Middle-Aged and Older Americans.AARP examined older Americans' responses to the economy in April 2008. The finding: that people over 45 share concerns about both the current and future states of the nation's economy. The downturn is characterized as a triple-threat combination of stagflation (slow growth + high unemployment), job losses and rising fuel prices.As a result of these macroeconomic concerns, older people have adapted their personal microeconomic be...
Source: Health Populi - May 16, 2008
Lessons learned from switching sides
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An email letter from a staff member to me. Many, many helpful suggestions that we will work on.Paul – I have unfortunately have had the experience over the past several months to switch sides from supporting MDs provide care to patients to that of becoming the loved one of a patient. My mom was admitted here on 12/29/08 with what was thought to be a stroke. After five weeks of treatment and the inability to control seizures that she was having every three minutes, it was discovered that it was not a stroke, but instead a Grade IV Glioblastoma.Since my mom’s first admission, she has been readmitted four other times. In ...
Source: Running a hospital - May 16, 2008
Change of Shift
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Great news, it is time for Change of shift again, this time hosted by Dr Emer over at Parallel Universes, there are some great posts once again. I for one am looking forward to having a good read over this weekend! More from me later!
Source: Life in the NHS - May 16, 2008 Authors: Julie Tags: Change of Shift Nursing
What does the future hold for work comp TPAs?
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For some, red ink. Most workers comp TPAs are struggling. The softening market has pushed many larger employers back to insured programs - for good reason. If a policyholder can buy fully-insured coverage for less than their projected losses plus...
Source: Managed Care Matters - May 16, 2008 Authors: jpaduda at healthstrategyassoc.com Tags: Workers Comp
Podcast interview with David Hom, Chairman of the Center for Health Value Innovation (transcript)
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This is a transcript of my recent podcast interview with David Hom, Chairman of the Center for Health Value Innovation.
David Williams: This is David Williams, Co founder of MedPharma Partners and author of the Health Business blog. I am at Consumer Health World in Las Vegas where I spoke today with David Hom, Chairman of the Board of the Center for Health Value Innovation.
David and I spoke about value based insurance design and health care consumerism. Hom would like to see consumers become CEOs of their own care, and he believes we are at the cusp of using information technology effectively to enable consumers to adhere...
Source: Health Business Blog - May 15, 2008 Authors: David E. Williams of the Health business blog Tags: Health plans Podcast
Health Wonk Review is up at Healthcare Economist
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Check out the latest edition of the Health Wonk Review at Healthcare Economist.
Source: Health Business Blog - May 15, 2008 Authors: David E. Williams of the Health business blog Tags: Blogs Announcements
Searching vs. using health information: the "just looking" mode of health search
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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. As the chart details, 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 claim...
Source: Health Populi - May 15, 2008
League table obsession
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My hubby spends time on a Saturday or Sunday evening studying the football league tables after the weekend’s games have taken place. Now at the end of the season Manchester United have beaten Chelsea on goal difference, hubby is sure if that game 3 weeks ago had been won rather than drawn then Chelsea would be top. Football is a game (though many people would hate me to say so) and the league table is based on how many games you win, lose or draw and the number of goals you score or concede. What though are the league table the government has become so obsessed with publishing show?
As a parent I can apparently judge...
Source: Life in the NHS - May 15, 2008 Authors: Julie Tags: Education Football NHS
Two drugs, one problem
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Our head of pharmacy, Frank Mitrano, likes to say that he wishes that all drugs were packaged in exactly the same sized containers, with covers and lids of the same color, and with simple black lettering on a white background in the same font. Why? Because it is human nature to assume that a vial of medicine with a green cap and green lettering is, in fact, the medicine you were looking for, even if it is something quite different. And, also, the more layers of safety protection information systems and other technology that you have in place, the more likely you are to assume that you have the correct drug and the less lik...
Source: Running a hospital - May 14, 2008
Health Business Blog on Medscape
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As part of the preparation for Grand Rounds (hosted here yesterday), Nicholas Genes profiled me on Medscape. This year’s writeup focuses on some of my more strident positions: in favor of immigration and in defense of commercial health plans. Last year’s piece emphasized my work in medical tourism and the year before’s was a general introduction.
Source: Health Business Blog - May 14, 2008 Authors: David E. Williams of the Health business blog Tags: Blogs Announcements
Wellness, a global business imperative: PwC
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Chronic disease will account for 2/3 of all deaths globally in the next 25 years."We have to move from illness to wellness. Businesses will have to invest in wellness. There is no choice. It's not philanthropy. It's enlightened self-interest," according to Shrinivas Shanbhag, the Medical Adviser at Reliance Industries in India.A new report from PricewaterhouseCoopers (PwC) and the World Economic Forum, Working Towards Wellness: The Business Rationale, details the future of chronic disease to 2030. Globally, today's emerging BRIC economies -- Brazil, Russia, India and China -- will lose millions of productive life-years due...
Source: Health Populi - May 14, 2008
Drug costs in workers comp - and the answer is
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I've just about completed compiling results of the Fifth Annual Survey of Prescription Drug Management in Workers Comp. While the report won't be completed for a couple weeks, here are a few factoids that are rather compelling. Drug trend continues...
Source: Managed Care Matters - May 14, 2008 Authors: jpaduda at healthstrategyassoc.com
Kadlec Decision Reversed by Appeals Court
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Information excerpted from an article by Michael Callahan, Katten Muchin Rosenman LLP
Source: MSSPNexus Blog - May 14, 2008 Authors: Rita Schwab
The Perfect Storm in Healthcare?
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by Nick Jacobs
What’s this generation coming to? It started some years ago with new rules for residents. They no longer were permitted to be worked 80+ hours per week as part of their residency. In fact, many residents actually keep time sheets and then tell their MD/Professors when their work week is complete. It wasn’t that many generations ago that student nurses and residents were the only people working the night shift in even prestigious medical centers.
What else is happening? New generations of physicians are actually seeking to attempt to balance their work time with their free time. A front page ar...
Source: hospital impact - May 13, 2008 Authors: hospitaltony
SPIRIT can shred red tape
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A recent report on the SPIRIT log shows that process improvement can show up in unexpected ways. Nice to see residents using it, too! We prefer that they spend time with patients rather than dealing with red tape. With an organization of our size and history, we can expect bureaucratic glitches to show up a lot.Location of Problem: Employee Health & Emergency DepartmentProblem: I was recently splashed in the operating room and directed by employee health to have my labs drawn in the ED since it was 4:30pm. In the ED, my vitals were taken and my blood was drawn by an RN. The triage nurse of the ED confirmed that obvious...
Source: Running a hospital - May 13, 2008
Surgical workaround
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A note from one of our surgeons:Paul,I'm writing this out of frustration. The door C334 to the male locker room in the Shapiro OR has been dysfunctional for weeks. You need an access card to open it. The mechanism is faulty and each morning for some time now surgeons, techs etc have had to battle to get in the room and change for the OR.Efforts have been made to 'repair' the mechanism but nothing has worked.Please forward this to the appropriate person and have them leave the door unlocked till such time as it can work effectively. People have had to force the door open at times which is causing more damage ( to the door a...
Source: Running a hospital - May 13, 2008
What we can all agree on: the post-latte economy
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There's a new New Yorker cartoon I'm using in a presentation today to a health plan titled, "Starbucks goes downscale: drinks for the post-latte economy." Three new drinks are offered in the economic downturn-menu: instant coffee with Cremora, the Big Gulp of "American joe," and my personal favorite, "The Floyduccino." It's this last drink I forecast will have the biggest uptake given the blues that we're all feeling due to economic woes.The Floyduccino is coffee with a shot of Wild Turkey: "good for what ails ya."In the latest Gallup poll published May 12, 2008, 9 in 10 Americans feel the economy is getting worse. Further...
Source: Health Populi - May 13, 2008
Grand Rounds 4:34 at the Health Business Blog
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Welcome to the latest edition of Grand Rounds at the Health Business Blog. This is my fourth time hosting (fifth if you include the April Fool’s edition).
We’ll start things out with a little fun before getting serious
Who says radiologists don’t have a sense of humor? Not Totally Rad’s iPhluoroscope is the latest antidote to the cocktail party consult syndrome.
Clinical Cases and Images advises that starting to drink in middle age may reduce cardiovascular events as much as statins do. If the effect is synergistic, expect to see combination products enter clinical trials soon. Liquitor anyone?
And ...
Source: Health Business Blog - May 13, 2008 Authors: David E. Williams of the Health business blog Tags: Blogs
Placebo surgery
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You can read a good take on placebo surgery at Science Channel.
This leads me to an extremely bizarre — but nevertheless intriguing — thought: If fake surgery actually helps study subjects, what about using it to treat ordinary patients, particularly ones for whom no other effective treatment seems to be available?
Source: Health Business Blog - May 12, 2008 Authors: David E. Williams of the Health business blog Tags: Blogs Research
Telemedicine beats the emergency room
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Several years ago, while seeking to establish the ROI for RelayHealth, we found that users of RelayHealth had lower spending for emergency department visits than the control group. The explanation was reasonably straightforward: better, more timely access to physicians obviated the need to show up at the emergency room with its attendant costs, inconvenience and dangers.
Now a study from the University of Rochester has shown something similar. More than 25 percent of pediatric ED visits could be avoided through telemedicine. Researchers found that many ED visits were for non-emergency issues like sore throats and ear infec...
Source: Health Business Blog - May 12, 2008 Authors: David E. Williams of the Health business blog Tags: e-health
BIDMC Annual Nursing Awards Ceremony @ Fenway Park
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Source: Running a hospital - May 12, 2008
ePrescribing gathers steam at Brookings, the AMA and on The Hill
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ePrescribing = safety, lower costs, and better health care. This consensus was clear last week during a major meeting of stakeholders at The Brookings Institution discussing the prospects and barriers to ePrescribing (eRx).Matthew Holt and I wrote a report back in 2006 for the California HealthCare Foundation where we discussed the opportunities and barriers for eRx. Two-and-one-half years have passed since that report was written. So 30 months later, continue to read this blog to learn about how Medicare, physicians, PBMs, Congress and pharmacies are getting into Kumbaya mode for eRx. While the actual number of ePrescribe...
Source: Health Populi - May 12, 2008
Celebrating Nurses Day
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In the UK we don’t tend to have a whole week celebrating nurses and nursing, but rather just the day. That day is today the birthday of Florence Nightingale, and let us just say this is pretty low key. Professions go through different patches in terms of popularity and whether those who are part of it are worthy. My assessment would be that nursing is going through a rocky time right now as it attempts to find its place. Traditionally nursing has been seen to be about caring, about providing a particular type of care for patients but increasingly it has been about developing new skills, perhaps specialising in partic...
Source: Life in the NHS - May 12, 2008 Authors: Julie Tags: Nursing
Triggers happy
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A year ago or so, I wrote about the introduction of our Triggers Program, a rapid response team approach to patients on medical floors who might soon decompensate or have other serious changes in their condition. The program has been incredibly successful in reducing mortality and morbidity. In fact the number of "codes" on our floors has gone down so dramatically that residents now need to practice emergency resuscitation mainly in the simulation center because so few actual patients need it.I recently asked a couple of our folks who were deeply engaged in the design and implementation of this program -- Dr. Michael Howel...
Source: Running a hospital - May 12, 2008
A few facts about Pharmacy Management in Workers Comp
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I'm knee deep in my annual survey of pharmacy management in workers' comp, and if I look at one more column of data I'm going to need a few class 2's myself. So in the interest of my sanity, here...
Source: Managed Care Matters - May 12, 2008 Authors: jpaduda at healthstrategyassoc.com
Hospital specialists assume national and state leadership roles
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From
Source: MSSPNexus Blog - May 11, 2008 Authors: Rita Schwab
ALERT: Food and Drug Administration (FDA) Heparin Recall for All Provider Types
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I’m reprinting this message I received from FDA:
Please help FDA spread the word about recalls of injectable heparin products and heparin flush solutions that may be contaminated with oversulfated chondroitin sulfate (OSCS). Affected heparin products have been found in medical care facilities in one state since the recall announcement. Although product recall instructions were widely distributed, they may not have been fully acted upon at all sites where heparin is used. There have been many reports of deaths associated with allergic or hypotensive symptoms after heparin administration (see FDA link at http://www.fda...
Source: Health Business Blog - May 9, 2008 Authors: David E. Williams of the Health business blog Tags: Pharma Announcements
60 Days in Umbria
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If you are in Cambridge, please visit the BAAK Gallery at 35 Brattle Street to see the paintings of Kathryn Sanfilippo, a Boston-based (450 Harrison Avenue) artist displaying paintings inspired by her time in Italy. The one above is called Countryside and gives you a sense of the colors and broad brush strokes used by Kathryn. The show opened tonight and goes until June 5, when the Italian Consulate presents it at the Federal Reserve Building.P.S. Health care folks in Atlanta and Columbus might recognize the last name, also associated with brother Fred, CEO of Emory's Woodruff Health Sciences Center and Chairman of Emory H...
Source: Running a hospital - May 9, 2008
A new idea: The 338 Foundation
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by Tony Chen
I have an idea that I wanted to share with you - please give me your honest opinion (i.e. you can tell me if I'm crazy!). I would love to find others to collaborate with on this. So, if you're interested, contact me directly (tony at hospitalimpact dot org) or comment below. Obviously, the idea is still very rough, but hopefully you'll see where I'm heading. And hopefully, we can refine it together.
What do you think about a new a philanthropic/VC hybrid that invests in preventive health projects that yield at least 338% ROI? (thus the name "The 338 Foundation.")
I'm going on 2 key assumptions:
1. Preventi...
Source: hospital impact - May 9, 2008 Authors: hospitaltony
Podcast interview with Richard Noffsinger, CEO of SafeMed, a clinical decision support company (transcript)
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This is a transcript of my recent podcast interview with Richard Noffsinger, CEO of SafeMed.
David Williams: This is David Williams, co founder of MedPharma Partners and author of the Health Business Blog.
I spoke today with Rich Noffsinger, CEO of SafeMed, a clinical decision support company based in San Diego. I first met SafeMed’s founder, Dr. Ahmed Ghouri, a couple of years ago when the company was starting a pilot at Beth Israel Deaconess Medical Center in Boston. I liked the demo I saw then and I have been following the company ever since.
In our interview today, Noffsinger brought me up to speed on SafeMedR...
Source: Health Business Blog - May 9, 2008 Authors: David E. Williams of the Health business blog Tags: e-health Podcast
Lean leaves well-oiled gears
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Remember when I told the story about using Lean process improvement techniques to enhance the service in our orthopaedic clinic? That was over a year ago.Here's a note from a recent patient, a local student:I just had to share this with you because it was such a neat feeling at the time. I saw Dr. Gebhardt yesterday (my orthopaedic surgeon) and there there was no wait for anything at all. Checking in was a breeze. I saw Dr. Gebhardt exactly on time. Afterwards, I was worried about getting the x-rays because the whole waiting room was full, but again, there was no wait. I've read about lean, SPIRIT, and process improvement ...
Source: Running a hospital - May 9, 2008
Mind your manners
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Dr. Michael Kahn, from our Department of Pyschiatry, has published an article in the New England Journal of Medicine that suggests that doctors enhance their relationship with patients when they deal with patients in a polite manner. Here is a summary on the AOL web site, along with a poll on the issue. I like this summary: Etiquette-based medicine . . . "would put professionalism and patient satisfaction at the center of the clinical encounter and bring back some of the elements of ritual that have always been an important part of the healing profession."NEJM has published the entire article as freely available to the pub...
Source: Running a hospital - May 9, 2008
Retirement forecast: work longer, see fewer medical specialists, take care of yourself
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Older workers will work longer to keep health coverage. But even as they do so, they'll confront a dwindling supply of medical specialists.Watson Wyatt (WW) found that people over 50 years of age who receive health benefits from employers and don't expect to receive these benefits in retirement are 16.5 percentage points less likely to retire than people who have health coverage from another source (such as a spouse’s health insurance plan, Medicare/Medicaid, COBRA). In its report, Predictive Factors for Retirement Timing, WW identifies the main factors influencing when Americans will retire, including health and non-hea...
Source: Health Populi - May 9, 2008
Dear Interns
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As each new class of interns arrives at the hospital, it is important to provide a context for their experience. Most of their advice and training comes from their clinical leaders, but the CEO has a role, too. Here are excerpts from one of my notes to the current class:Dear Interns,I'd like to turn to some important matters facing BIDMC and explain your role in helping us achieve some very important goals. The context is this: While you as doctors -- along with others who have come before you -- have received excellent training in biology, disease, diagnostics, and treatment, there is a growing part of clinical care that ...
Source: Running a hospital - May 9, 2008
Rounding up the week
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For a short working week (4 days one of which has only just started) I am feeling incredibly weary. Summer seems to have arrived early, which is no bad thing since we have suffered a miserable end to winter and most of spring; rain, hail, wind often all in one day. What is more my week has felt a little odd. From the person who found my blog through searching to purchase the ability to inseminate their chihuahua (you know that kind of small dog) which, while I know a variety of things, that is not one of them. Then there was a very strange dream which involved me flying off somewhere not too far away (it was a short flight...
Source: Life in the NHS - May 9, 2008 Authors: Julie Tags: Blogging Homelife Work
NCCI Conference - the Rousmaniere Report
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Friend and colleague Peter Rousmaniere recently attended the NCCI conference and was kind enough to provide a comprehensive report. Here it is, and thank Peter when you see him....
Source: Managed Care Matters - May 9, 2008 Authors: jpaduda at healthstrategyassoc.com Tags: Workers Comp
Shooting yourself in the head
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I recently gave a keynote speech to a group of insurance brokers affiliated with the Institute for Work Comp Professionals; the talk focused on cost drivers in WC, with special emphasis on medical costs. The part of the talk that...
Source: Managed Care Matters - May 9, 2008 Authors: jpaduda at healthstrategyassoc.com Tags: Workers Comp
Grand Rounds to be hosted at the Health Business Blog
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I’m hosting the upcoming Grand Rounds. Please submit your favorite post to me via email. The deadline is Sunday at midnight EDT. There is no theme.
Source: Health Business Blog - May 8, 2008 Authors: David E. Williams of the Health business blog Tags: Blogs Announcements
Do you trust your blogger?
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Interesting post by Bill Ives, referring to comments by Andrew McAfee at Harvard Business School about Enterprise 2.0, about trusting bloggers, and the role of blogs in business communication. Bill and Andrew and Jessica Lipnack, also cited in the post, are key observers and thought leaders in this arena. Jessica asked yesterday whether email is obsolete. See the last paragraph in a related story on that topic below.
Source: Running a hospital - May 8, 2008
Retail meds: pharmacy update and Wal-Mart price cuts
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Wal-Mart continued its first-mover tactics in health by dropping the price of prescriptions again. This time, the target (sorry for the pun) is maintenance meds which Wal-Mart will price at $10 for 90 days' supply. This move puts Wal-Mart squarely in the pharmacy benefits management (PBM) segment vis-à-vis ExpressScripts, Medco, and the big PBM players. The 3-month mail order med business is the lucrative turf of PBMs. Wal-Mart's first move into this space was in 2006 when the company priced many 30-day scrips at $4, shaking up the industry. I wrote about that market disruption here in January 2008.Wal-Mart will also offe...
Source: Health Populi - May 8, 2008
Podcast interview with Dr. Michael Parkinson, President of the American College of Preventive Medicine
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Michael D. Parkinson, MD, MPH has had an interesting career. In this podcast interview, Dr. Parkinson describes how his experience as an Air Force physician taught him about how personal health behaviors and organizational culture impact health and health care costs. He explains why he left government service to become Chief Health and Medical Officer with consumer-directed health plan startup Lumenos, where he emphasized prevention and chronic care management. He also discusses his current role as President of the American College of Preventive Medicine.
Parkinson and I discussed the interaction between prevention and cos...
Source: Health Business Blog - May 8, 2008 Authors: David E. Williams of the Health business blogdwilliams at mppllc.com Tags: Health plans Entrepreneurs Podcast
The cost of ignorance
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Many payers look at 'medical' as a line item and nothing more. This myopia, this failure to look deeper, to try to understand what drives medical, is perhaps the most significant shortcoming in the industry. Many readers will dismiss this...
Source: Managed Care Matters - May 8, 2008 Authors: jpaduda at healthstrategyassoc.com Tags: Workers Comp
Podcast interview with Dr. Jason Yap, Singapore Medicine
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I interviewed Dr. Jason Yap at Consumer Health World in Las Vegas. He is Director of Healthcare Services at the Singapore Tourism Board and part of the multi-agency Singapore Medicine Initiative, the goal of which is to promote, develop and maintain Singapore as an international medical hub.
I first met Jason a year ago and he hosted me on a tour of hospitals in Singapore last summer. We’ve spoken in the past about medical tourism, but in this interview I focused on Singapore’s health care system and the potential lessons for the US.
Singapore spends less than 4 percent of its GDP on health care yet has univers...
Source: Health Business Blog - May 7, 2008 Authors: David E. Williams of the Health business blogdwilliams at mppllc.com Tags: Policy and politics International Podcast
Employer-based health care erodes U.S. global competition: A New America report
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The world is flat, but American manufacturers have known that since before Tom Friedman published the book on the subject. Globalization means American companies compete with foreign trade partners. The New America Foundation calculates that U.S. manufacturers pay an average of $2.38 an hour for health benefits, while trade partners pay only $0.96 an hour.That's the bottom-line in the Foundation's paper, Employer Health Costs in a Global Economy: A Competitive Disadvantage for U.S. Firms.The percent of payroll devoted to health benefits is about 13% for American manufacturers, and 5% for foreign trade partners.That adds up...
Source: Health Populi - May 7, 2008
More Gems from the Estes Park Institute Healthcare Conference
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Here are a few more tidbits from my Estes Park Institute conference notes:
Collegial Intervention:
The suicide rate for male physicians is 1.5 X higher than the general population.
The suicide rate for female physicians is 2 X higher than the general population.
Collegial intervention programs can help. Develop policies that encourage early intervention by medical staff leaders, and procedures that legally protect their efforts.
Conflict of Interest:
When a member of a voting body has a conflict of interest with regard to a matter under consideration, not only should the individual refrain from voting on the m...
Source: MSSPNexus Blog - May 7, 2008 Authors: Rita Schwab
Ingenix can't catch a break
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Ingenix has had a tough few months. The latest injury comes in the form of a suit filed by a Connecticut man, seeking class action status based on allegations that the United HealthCare sub engaged in an "alleged conspiracy in...
Source: Managed Care Matters - May 7, 2008 Authors: jpaduda at healthstrategyassoc.com Tags: Manage Care - Group Health
Midcourse lessons from SPIRIT
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Here are some comments made after today's BIDMC SPIRIT training session (see some of the participants above). We are now winding down on training the first 600 people. As you can see, people quickly get to the core issues, problems, and opportunities. This is about where we expected to be at this point in the process. After all, we are introducing new concepts of empowerment, problem identification, and problem solving -- and sometimes people are confused or nervous. The suggestions from these trainees are exceedingly helpful. But look, too, at the last comment: Key messages are starting to come through. Then, see a bit of...
Source: Running a hospital - May 6, 2008
Grand Rounds is up at Suture for a Living
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Check out the latest edition of Grand Rounds, hosted at Suture for a Living. I’ll be hosting next week so feel free to email your submissions.
Source: Health Business Blog - May 6, 2008 Authors: David E. Williams of the Health business blog Tags: Blogs Announcements
New mom? Check this.
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It turns out that new mothers are particularly at risk for back injuries for a while after childbirth because of hormonal changes. Kathleen Shillue, one of our physical therapists, has prepared this short video called "Handling the baby without hurting yourself," to help people avoid injury. Please check it out.
Source: Running a hospital - May 6, 2008
