The Health Care Blog

QUALITY/CONSUMERISM: Treating patients like, well, people?

I've spent the last two days in a huge planning conference for Ascension Health, a Catholic multi-system (or multi-Ministry) chain that's looking to transform its future. In fact they have a huge ongoing project they term their Call to Action...

HEALTH PLANS/POLICY: Consumer directed health plans

I saw a talk yesterday by Mike Parkinson, Chief Medical Officer of Lumenos--one of the leaders in the emerging CDHP movement. Lumenos has around 54 clients with around 100,000 covered lives in its products sold to self-insured employers. Another commenter...

TECHNOLOGY: JSK's HIMSS review

Jane Sarasohn Kahn has some interesting things to say about the HIMSS exhibit hall in her iHealthBeat column. She believes that real progress is being made, and declares that less hype than usual is apparent this year!

HOSPITALS: Tenet....and now the good news!

As the readers of THCB know, Tenet hasn't had a whole lot of good news lately. But the rot maybe stopping. Blue Cross of California has been after Tenet for unnecessary surgery in Modesto, assuming that there was the same...

PHARMA: Drugs cost too much but they work

One fundamental challenge of the next period in our healthcare system concerns drugs. We know that they are very useful in combating disease and reducing costs. We also know that, as the AP reports, drugs cost too much. The political...

POLICY: Abramovitz on Why Consumer-Directed Health Care Won't Fly

This is a little late but the folks over at Managed Care magazine had a nice start of year forecasting piece in their January edition which has several forecasts of the next five years. Particularly interesting is Ken Abramowitz's piece...

QUALITY QUICKIE: Interview with Robert Wacther

The San Francisco chronicle had a couple of interesting pieces that I read on the plane east this morning. The first was an interview with Robert Wachter about his new book Internal Bleeding. He has a lot of sensible opinions...

TECHNOLOGY: El Camino vies to be Hospital of the future once more

The other article in the SF Chronicle was about El Camino hospital, a community hospital in Mountain View, CA right in the heart of Silicon Valley. El Camino had one of the first computerized hospital information systems, made for them...

HOSPITALS/POLICY: Hospitals and the uninsured--a discount's OK

Hospitals that have been complaining that Medicare won't let them discount to the uninsured have been told that by the Bush Administration they are wrong and that they can. Last year I wrote about how providers have been charging cash...

TECHNOLOGY: CHW goes with Cerner

Having been rebuffed in the UK, Cerner is making up for lost time and getting religion--snapping up its second big deal with a big Catholic chain in as many months. It already has a deal with the big mid-western Catholic...

PHARMA: Prescription drug sales over $216 billion in 2003

Just in case you were overly concerned about all the problems that pharma companies were having, (yes, I thought you were!), you might need reminding what a strong overall business this is. IMS reports that US prescription drug sales were...

POLICY: Quick update to the Policy Wonk's Medicaid piece from Ross the Bloviator

Ross at The Bloviator is on a high and rightly so! He has great news about a new baby boy, and new job and a guaranteed lottery win (well maybe not the last one, but then he probably failed stats...

PHARMA: Big Pharma influencing formulary decision makers

The Pharma Veteran points me towards this story surrounding some slightly tawdry business in creation of the Pennsylvania state formulary. The Veteran says: This furthers the conviction that healthcare is either tragedy or farce. It reinforces several conclusions we'd already...

PHARMA: Headline news--Seniors with better drug coverage use more, and more expensive drugs

Health Affairs has a new study on the web that confirms the blindingly obvious. People with better insurance coverage will use more health services than those without insurance. What's interesting about this study is that it looked at the difference...

PBMs: Zero sum big swings in the PBM world

If you've been reading THCB for a while you'll know that I'm not overall bullish on PBMs. But of course in any market if you win an account from your competitor that's responsible for over 14% of the competitors' earnings,...

TECHNOLOGY: Getting the data from the machine that goes "ping" into the EMR

As Monty Python pointed out, American hospitals are full of machines that go "Ping". Health Data Management has a long but very interesting article on the challenges involved in getting what used to be analog but is now digital data...

PHARMA : Big investor unloads some AstraZeneca shares

The Wallenberg family of Sweden own some 5% of Astra-Zeneca via their Investor AB fund. Last week they sold some 30% of their holdings. As you'll recall A-Z's future performance and the performance of its new statin Crestor have been...

TECHNOLOGY: Thompson wants to use Medicare fraud money for IT

Tommy Thompson may just get a few things right now he's decided to leave. First he corrects the shameful rewrite his department did of a report on racial disparities in health and now Modern Healthcare reports that he's recommending using...

TECHNOLOLGY: Kaiser's having an Epic time, dude!

Health-IT World reports that Kaiser's system-wide installation of the Epic EMR is going pretty well. Given that this is probably the biggest single EMR project going out-side of the UK and that Kaiser for all its faults is on the...

POLICY: Medicaid used as a way for the Feds to batter the states? with UPDATE Tues afternoon

While you may have thought that the New York Times was up on the news, the careful reader of THCB might have noticed that today's story, titled U.S. Nears Clash With Governors on Medicaid Cost, shares exactly the theme of...

PHARMA: The Pharma company's fear of the consumer

In an probably futile attempt to improve the literary tone here at THCB, I stole this post's title from an early Wim Wenders movie. But like the hero of the movie, the dual nature of the pharma companies' relationship with...

POLICY: Medicare costs and HMO enrollment, with long UPDATE

I came across this article from Jeff Lemieux who used to be the head staffer for the Commission on the Future of Medicare under Breaux and Thomas. (The commission never went anywhere, but that surely wasn't his fault). The article...

PBMs: These are the good-old days for the PBMs

Caremark's (and AdvancePCS) stock jumped today because (as expected) the FTC has approved their merger. Both these stocks are at significant all time highs (or at least Caremark is up 8-fold since it got out of the physician business in...

QUALITY QUICKIE: Prescribing wrong drugs happens too often

A CDC study shows that one prescription in every twelve written for elderly patients is potentially dangerous. The full abstract is here while here's the rather more user-friendly news release. What's somewheat depressing is that this is 2000 data and...

HOSPITALS: Is HCA having a Tenet-like moment?

From the TCHB Sacramento bureau, Matt Quinn has some comments on a HCA hospital that is on the verge of losing Medicare reimbursement status due to violations of the Medicare safety regs. Matt writes: Is HCA the next Tenet (hasn't...

PHARMA: Business, Science Clash at Medical Journal

The Washington Post reports on a story about the journal Dialysis & Transplantation allegedly pulling an article critical of the use of the drug Epogen. Apparently the commercial staff over-ruled the editor, fearful that the negative article might cost them...

TECHNOLOGY: XML as another savior for clinical computing?

Robert Mittman has another iHealthbeat technology column, this time on the progress in health care of XML. It's well worth a read. Particularly interesting is the suggestion that, by formatting all those transcribed dictated notes which are currently in word...

HOSPITALS: Emergency rooms suffering from crowding, non-emergent patients and losing specialty coverage

The Schumacher Group is out with a pretty interesting survey on emergency room issues, with implications for hospitals and payers in a couple of areas. It says basically that: -- for most emergency rooms a lack of specialists both on...

TECHNOLOGY: PDA use by pediatricians

In an article in Pediatrics Carroll and Christakis report that 35% of pediatricians use a PDA at work. So for that 35%, what do they actually do with them? 80% use it for a drug reference and 65% for scheduling...

POLICY/EMPLOYERS: All you need to know about health care is in this article

Everything you ever wanted to know about the US system is buried in this article in the NY times article called Whose Problem Is Health Care?. The interesting core paragraphs tell you that After corporate income taxes, employee benefits are...

GENERAL: Monday morning grab-bag

I'll be back tomorrow (hopefully) with some interesting stuff about the argument around drug prices, but for now, here's a varied few shorts that you can look at. TECHNOLOGY: Physician to patient communication online continues to make slow but visible...

TECHNOLOGY: Spending and adoption in the clinical IT market -- Is the S curve getting up off the floor?

You know that all technology diffuses in an "S" curve, and the trick is figuring out when the line goes up from snaking along the floor and starts heading up sharply--the "hockey stick" growth phase. Whisper it quietly but in...

INDUSTRY: Medicare reporting may add to Tenet's woes.

Medicare is apparently going to be getting into the game of paying (very modestly) for quality measures, or more accurately modestly punishing for the lack of reporting on it. According to Health-IT World: The government said it would begin punishing...

POLICY: Too many physicians? UPDATE midday Friday

We've been told by COGME no less that there's an impending physician shortage, and today I reviewed a whole bunch of material for a hospital that looked like it was true. However, to put a spike in this balloon, an...

TECHNOLOGY: Boston Scientific's new stent near market

Boston Scientific is having a good run. Its sales are up and its new drug-eluting stent Taxus, which has been doing well outside the US, is close to approval here. J&J's Cypher stent is likely to be the main loser...

PHARMA: Public Image continues to go downhill

You may remember the story from the Industry Veteran a few weeks back about the massive price increase in Abbot's HIV drug, Norvir. Well the Sacramento Bee notes that things are close to going thermonuclear now. In a Jan. 20...

INTERNATIONAL: Money's tight at the NHS?

According to this piece of gossip masquerading as a news story British Surgeons have taken to closing wounds with paper clips. I grew up in Britain and to this day I use paper clips instead of cuff links when I...

PHARMA/GENOMICS: Incyte throws in the towel

When I went to a conference on Genomics at Northwestern University in 1997 there was great excitement that the human genome project was going to be finishing quicker than anticipated. There was also widespread controversy that one company, Incyte Pharmaceuticals,...

HEALTH PLANS: For-profit conversions don't really leave anyone Blue

Apologies for the appalling pun, but HSC is out with a very thorough and readable analysis of the for-profit conversion of many Blues plans, and what the impact of these conversions has been. They note that virtually all the converted...

Ouch! Internal Bleeding exposes medical errors

Modern Physician has an interview with Bob Wachter, who's new book is called Internal Bleeding. There are something in the region of 20 odd medical errors written up in the book, with a view to showing the system problems behind...

BLOGS: Congratulations, Don

Congrats to Don Johnson who's excellent blog The Business Word is one year old.

QUALITY QUICKIE: EBM goes mainstream (sort of)

With a hat-tip to Lisa Williams, this month's Atlantic Monthly Journal has the first article I've ever seen in a mainstream magazine on EBM. The author calls for a national clinical institute to supplant the NIH and AHCQ, and actually...

POLICY: Health savings accounts-the likely impact

Over at Medpundit, Sydney Smith quotes the WSJ on health care cost breakdowns and argues that HSAs will allow market intervention in the share of spending that goes to doctors and pharmaceuticals, and will bring both that spending under control...

TECHNOLOGY: Pain Control by virtual reality

In the course of some other research I ran across this fascinating site the Virtual Realty Pain Control at University of Washington's Human Interface Technology Lab. Extreme pain, such as that experienced by burn victims while having their wounds cleaned,...