The Health Care Blog

The Health Internet vs. the NHIN -- A Matter of Control, Cost, and Timing

By DAVID C. KIBBE and BRIAN KLEPPER There is growing tension within the Obama administration's health team over who will control health data exchange: everyone (including consumers and their doctors), or just large provider organizations. The public debate will be...
November 19, 2009 in Brian Klepper, David Kibbe, HITECH, NHIN, RHIOs, Web/Tech | Permalink | Comments (35)

Time to put aside the intellectual disputes for now

By Matthew Holt It’s always fun to see my friends beating each other up in public....and if you read down in the comments on the post published yesterday you’ll see a significant dispute between Maggie Mahar and the Klepper/Kibbe/Lazsweski/Enthoven team...
October 31, 2009 in Brian Klepper, David Kibbe, Maggie Mahar, Matthew Holt, Policy, Policy/Politics, Public Option, Robert Laszewski | Permalink | Comments (79)

Saving Health Care, Saving America

By BRIAN KLEPPER, DAVID C. KIBBE, ROBERT LASZEWSKI and ALAIN ENTHOVEN So far, Congress' response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives...
October 30, 2009 in Brian Klepper, Corruption, Current Affairs, David Kibbe, Marketplace, Policy, Policy/Politics, primary care, Reform, The Industry, Transparency | Permalink | Comments (46)

A Message to America's Physicians: Purchasing EHR Technology A Shaky State of Affairs

By DAVID C. KIBBE and BRIAN KLEPPER Much of the conversation and debate about physician EHR adoption has centered on the single issue of the (high) cost of purchase. However, we'd like to suggest that the situation is much more...
October 28, 2009 in Brian Klepper, David Kibbe, EHR, HITECH | Permalink | Comments (29)

Why Standards Matter 2: Health IT Enters a New Era of Regulatory Control

By DAVID C. KIBBE and BRIAN KLEPPER The recent history of electronic medical records in ambulatory care, or what we now call EHR (electronic health record) technology, can be divided roughly into three phases. Phase I, which lasted approximately 20...
October 14, 2009 in Brian Klepper, David Kibbe, EHR, HIT, HITECH, Technology | Permalink | Comments (10)

Will Republicans Be Spoilers Or Problem Solvers on Health Care Reform?

By BRIAN KLEPPER and DAVID C. KIBBE In theory Congress' return from recess next week could offer a new beginning to the health care reform process, giving everyone a chance to take a deep breath and recalibrate the components of...
September 2, 2009 in Brian Klepper, Congress, David Kibbe, Reform | Permalink | Comments (12)

Advice For State REC Planners

By DAVID C. KIBBE & BRIAN KLEPPER On August 20th, HHS Secretary Kathleen Sebelius and ONC head David Blumenthal announced $598 million in grants to set up about 70 "regional extension centers" (RECs) that will help physicians select and implement...
August 31, 2009 in Brian Klepper, David Kibbe, EHR, HIT, HITECH, REC, Reform | Permalink | Comments (4)

Health Care Reform's Deeper Problems

By BRIAN KLEPPER and DAVID C. KIBBE Congress' health care reform debate has highlighted how American governance is broken and the difficulty of addressing our national problems. Take, for example, whether health care is in crisis at all. Conservative commentators...
August 27, 2009 in Brian Klepper, Congress, David Kibbe, Democratic Party, Reform | Permalink | Comments (56)

Why Standards Matter (1): The True Meaning of Interoperability

By DAVID C. KIBBE and BRIAN KLEPPER Americans are generally skeptical of words that otherwise intelligent and articulate people can't pronounce. "Interoperability," like nu-cu-lar, is one of these. After a while, these words can take on a mystique all their...
August 22, 2009 in Brian Klepper, David Kibbe, e-patients, EHR, Electronic Medical Records, Technology | Permalink | Comments (0)

Finally, A Reasonable Plan for Certification of EHR Technologies

By DAVID C. KIBBE and BRIAN KLEPPER A caution to readers: This post is about methods for certifying Electronic Health Record (EHR) technologies used by physicians, medical practices, and hospitals who hope to qualify for federal incentive payments under the...
August 4, 2009 in Brian Klepper, David Kibbe, HHS, Marketplace, Meaningful Use, Policy, Policy/Politics, Reform, Technology, The Industry, Web/Tech | Permalink | Comments (28)

Behind the Curtain: Wendell Potter on the Industry's Management of Care and Reform

By BRIAN KLEPPER Stop what you're doing and take out a half-hour to watch this week's superb Bill Moyers' 3-part show, especially the extended interview with Wendell Potter, former CIGNA VP Corporate Communications, for a frank, insider's discussion of how...
July 10, 2009 in Brian Klepper, Health Plans, Policy/Politics, Reform | Permalink | Comments (9)

Why Congress Should Consider Bob Laszewski's Health Care Affordability Model

By BRIAN KLEPPER Over the last few months, I have become increasingly disheartened over the prospects for meaningful health care reform. First, the process is terribly conflicted, and it shows. In the first quarter of 2009, the Center for Responsive...
July 9, 2009 in Affordability Model, Brian Klepper, Current Affairs, Marketplace, Policy, Policy/Politics, Reform, Robert Laszewski, The Industry | Permalink | Comments (40)

A Dream of Reason

By BRIAN KLEPPER and DAVID KIBBE The dream of reason did not take power into account...Modern medicine is one of those extraordinary works of reason...But medicine is also a world of power. -Paul Starr, The Social Transformation of American Medicine,...
June 22, 2009 in Brian Klepper, Consumers, David Kibbe, e-patients, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (8)

The Health Industry's Achilles Heel

By BRIAN KLEPPER and DAVID C. KIBBE "You never want a serious crisis to go to waste." - Rahm Emanuel, White House Chief of Staff Timing matters. The health industry has demonstrated steadfast resistance to reforms, but its recently diminished...
June 10, 2009 in Brian Klepper, David Kibbe, Health Plans, Obama administration, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (15) | TrackBack

Bringing Patients into the Health IT Conversation About "Meaningful Use"

By DAVID C. KIBBE and BRIAN KLEPPER The Obama health team at HHS and ONC are gradually establishing the rules that will determine how approximately $34 billion in ARRA/HITECH funds are spent on health IT over the next several years....
May 21, 2009 in Brian Klepper, Consumers, David Kibbe, Electronic Medical Records, Google, Health 2.0, Jane Sarasohn-Kahn, Marketplace, Policy, Policy/Politics, Web/Tech | Permalink | Comments (35)

An Open Letter to the New National Coordinator for Health IT: Part 3 -- Certification As The Elephant in Health IT's Living Room

By DAVID C. KIBBE and BRIAN KLEPPER In the first and second parts of this series we talked about how and why there is no universal definition for the term "EHR." Instead there is a legitimate, growing debate about the...
May 8, 2009 in Brian Klepper, David Kibbe, e-patients, Electronic Medical Records, Health 2.0, Obama administration, Online Communities, Policy, Policy/Politics, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (20)

An Open Letter to the New National Coordinator for Health IT - Untying HITECH's Gordian Knot: Part 1

By DAVID C. KIBBE & BRIAN KLEPPER Congratulations to David Blumenthal on being named National Coordinator for Health Information Technology (ONCHIT). Dr. Blumenthal will be the person most responsible for the rules and distribution of the American Recovery and Reinvestment...
April 26, 2009 in Brian Klepper, David Kibbe, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (19)

An Open Letter to the New National Coordinator for Health IT: Part 2 - Opening the Aperture of Innovation

By DAVID C. KIBBE & BRIAN KLEPPER One of the important decisions before Dr. Blumenthal and his colleagues at ONC and HHS is whether the national health information network will be one of closed appliances that bundle together proprietary hardware,...
April 22, 2009 in Brian Klepper, David Kibbe, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (21)

A Self-Fulfilling Prophecy: The Continuity of Care Record Gains Ground As A Standard

By BRIAN KLEPPER We live in a time of such great progress in so many arenas that, too often and without a second thought, we take significant advances for granted. But, now and then, we should catalog the steps forward,...
April 10, 2009 in Brian Klepper, Consumers, David Kibbe, Electronic Medical Records, Google, Health 2.0, Personalized Medicine, Policy, Policy/Politics, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (21)

From Health 2.0 meets Ix: A Breathtaking Display of Possibilities

By BRIAN KLEPPER (Boston) Jane Sarasohn-Kahn and I were quickly comparing notes this morning. Our impression is that, compared to past meetings, this one seems more characterized by doers than observers. This conference brings together a dizzying array of tools...
April 2, 2009 in Brian Klepper, Conferences, Health 2.0, Joshua Seidman, Matthew Holt, Web/Tech | Permalink | Comments (5)

Will CIGNA Remake The Health Plan Marketplace?

By BRIAN KLEPPER America’s health plans are floundering. If their job has been to provide the nation’s mainstream families with access to affordable care (let’s leave quality out of it for the moment), they have failed miserably, though they were...
March 30, 2009 in Brian Klepper, Health 2.0, Health Plans, Marketplace, primary care, The Industry | Permalink | Comments (15)

Is the Healthcare Economy Rightsizing?

By Brian Klepper and David C. Kibbe More than at any time in recent memory, powerful forces are buffeting the health care sector. We are in the midst of profound upheaval, driven by market and policy responses to the industry's...
March 12, 2009 in Brian Klepper, Current Affairs, David Kibbe, Economics, Health Plans, Marketplace, Medical Devices, Policy, Policy/Politics, The Industry | Permalink | Comments (33)

Five Recommendations for an ONC Head Who Understands Health IT Innovation

By David C. Kibbe, Brian Klepper and John Moore. Now that the legislative language of the HITECH Act -- the $20 billion health IT allocation within the economic stimulus package -- has been set, it's time to identify a National...
March 6, 2009 in Brian Klepper, Current Affairs, David Kibbe, Electronic Medical Records, evidenced-based medicine, Health 2.0, Physicians, Policy, Policy/Politics, primary care, public health, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (14)

Check Out The TED Talks

By Brian Klepper The uber-fabulous (and expensive) TED conference - 4 days, $6,000 and sold out a year in advance - a collection of some of the world's most thoughtful, innovative and high achieving individuals, has just finished, and many...
February 11, 2009 in Brian Klepper, Conferences | Permalink | Comments (0)

The AMA Wins a Round Against Accountability and Patient Information

By Brian Klepper On January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson...
February 6, 2009 in Brian Klepper, Consumers, Current Affairs, Health Plans, Policy, Policy/Politics, Quality, Technology, The Industry, Transparency | Permalink | Comments (12)

Dr. George Lundberg for Surgeon General

By Brian Klepper The report that Mr. Obama's Surgeon General choice might be neurosurgeon and CNN medical correspondent Dr. Sanjay Gupta produced an upwelling of strong opinion, particularly in the medical community. Some argued that Dr. Gupta has clearly demonstrated...
January 25, 2009 in Brian Klepper, Current Affairs, JAMA, Physicians, Policy/Politics, public health, The Industry, Transparency | Permalink | Comments (17)

Five "Shovel-Ready" Health Care Reforms

By Brian Klepper & David C. Kibbe Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We...
January 21, 2009 in Brian Klepper, David Kibbe, evidenced-based medicine, Health Plans, Marketplace, Obama administration, Physicians, Policy, Policy/Politics, primary care, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (18)

Welcome To Health Wonk Review - 1/09/09

By BRIAN KLEPPER Well, here we are at the beginning of 2009. On TV we’ve learned that the unlimited spending and brilliant, if socially pathological, heroics of Dr. Gregory House, unfailingly saves his patients from unknowable complexity and the abyss...
January 9, 2009 in Brian Klepper, health wonk review | Permalink | Comments (11)

Let's Reboot America's Health IT Conversation Part 2: Beyond EHRs

By DAVID KIBBE and BRIAN KLEPPER Yesterday we tried to put EHRs into perspective. They're important, and we can't effectively move health care forward without them. But they're only one of many important health IT functions. EHRs and health IT...
January 6, 2009 in Brian Klepper, David Kibbe, Health 2.0, Technology, The Industry, Transparency, User Generated Content, Web/Tech | Permalink | Comments (9)

Let's Reboot America's HIT Conversation Part 1: Putting EHRs in Context

By DAVID C. KIBBE & BRIAN KLEPPER Kibbe & Klepper are back with an update to their pre-Christmas piece on EHRs and the forthcoming Obama Administration's investment policy towards them. Lest you think that this is just a small group...
January 5, 2009 in Brian Klepper, David Kibbe, Health 2.0, Obama administration, Policy, Policy/Politics, The Industry, Transparency, User Generated Content, Web/Tech | Permalink | Comments (7)

Small Business Coverage: A Report from the Trenches

By Brian Klepper John Sinibaldi, a well-respected health insurance agent in St. Petersburg, Fla., has become prominent in Florida's broker community because he counsels and services a large book of small business clients and studiously tracks the macro trends that...
November 25, 2008 in Brian Klepper, Economics, Health Plans, The Industry | Permalink | Comments (4)

America's CEOs set priorities for Obama Administration

By Brian Klepper This past Monday and Tuesday, The Wall Street Journal convened an extraordinary conference of about 100 CEOs to develop and recommend issue priorities for the new Administration. (See the participant list here.) This meeting brought together the...
November 21, 2008 in Brian Klepper, Conferences, Economics, Quality, The Industry, Transparency | Permalink | Comments (11)

Daschle Tapped for HHS Secretary

By Brian Klepper The Caucus, the New York Times Political Blog, reports that senior Obama aides have said that Mr. Obama offered the nomination for Secretary of Health and Human Services to Tom Daschle of South Dakota, the former Democratic...
November 19, 2008 in Brian Klepper, Policy/Politics | Permalink | Comments (7)

Two Mea Culpas

By Brian Klepper Here's an attempt to recover from two mistakes yesterday. My post on our dismal prospects for real health care reform prompted a couple readers - thanks to Hal Andrews and Fred Goldstein - to take me to...
November 19, 2008 in Brian Klepper | Permalink | Comments (3)

The Changes We Need

By Brian Klepper These are, as the Chinese curse reputedly called them, interesting times. If the burst of new Democratic health care reform proposals is any indication, a fresh breeze of the Obama campaign's "Yes We Can" optimism is blowing...
November 18, 2008 in Brian Klepper, Marketplace, The Industry | Permalink | Comments (15)

Can Health Plans Explain Why They Aren't Re-Empowering Primary Care?

By Brian Klepper & David Kibbe Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan....
October 30, 2008 in Brian Klepper, Economics, Physicians, prevention, primary care, The Industry | Permalink | Comments (29)

An Impending Hanging: Will Health 2.0 Be Compromised By The Economic Downturn?

By Brian Klepper Nothing focuses the mind like an impending hanging. -- Samuel Johnson I've been preparing for tomorrow's 3rd Health 2.0 conference in San Francisco, where I'll join my pals Matthew, Indu Subaiya, Jane Sarasohn-Kahn and Michael Millenson amid...
October 21, 2008 in Brian Klepper, Economics, evidenced-based medicine, Health 2.0, Online Communities, Quality, The Industry, Transparency, User Generated Content, Web/Tech | Permalink | Comments (3)

Health Care and the Broader Economic Crisis

By Brian Klepper Over at HealthLeaders, Dr. Richard Reece and I have an article, Will Primary Care Be Re-Empowered By An Ailing Economy?, arguing that the turmoil in the larger US economy – and particularly the tightening of credit –...
October 2, 2008 in Brian Klepper, Economics | Permalink | Comments (9)

Chastened and More Sober, Harry and Louise Return

By Brian Klepper On Tuesday, Ron Pollack of Families USA led a call with bloggers -- unfortunately, I couldn't be on it -- to discuss Harry and Louise Return -- the new health reform campaign sponsored by five prominent organizations:...
August 21, 2008 in Brian Klepper, Policy/Politics, The Industry | Permalink | Comments (10)

T-Shirt Health 2.0 conference ego surfing

By Matthew Holt So this is how fashion insurgencies start…Brian Klepper sent me this email. I assume they felt like the two Hollywood starlets who show up at the Oscars wearing the same dress! “So David Foster, Director of Product...
August 13, 2008 in Brian Klepper, Health 2.0 | Permalink | Comments (3)

From Description To Action: The Future of Health 2.0 Tools

By Brian Klepper Last week, The Health Care Blog ran two articles about new wiki sites that will develop and continuously update medical information. A wiki is a “content collaborative” that allows anyone (or anyone authorized by the site) to...
July 28, 2008 in Brian Klepper, evidenced-based medicine, Health 2.0, The Industry | Permalink | Comments (0)

Health Systems' Ferocious Challenges

By Brian Klepper Lately, I've had interesting discussions with a thoughtful exec. at a major Western health system about the ferocious challenges facing hospitals and health systems. Her organization's internal conversations at the moment are centered, in part, on what...
July 22, 2008 in Brian Klepper, Economics, Hospitals, Medicare, The Industry, Transparency | Permalink | Comments (3)

Is Meaningful Health Care (Or Any Other Kind Of) Reform Possible?

By Brian Klepper Those who wait, ever hopefully, for real health reform might want to take a deep breath and take stock of a few realities. First, think about the fact that when the Democrats retook Congress, they tweaked but...
July 17, 2008 in Brian Klepper, Policy, Policy/Politics, The Industry | Permalink | Comments (27)

Health 2.0 Consciousness Dawns - Even In Jacksonville, FL!

by BRIAN KLEPPER Today, Matthew, Michael Millenson and I are converging at a Robert Wood Johnson Foundation conference on public reporting of health care pricing/performance information in Amelia Island, FL, three short barrier islands north of my home in Atlantic...
May 15, 2008 in Brian Klepper, Economics, Health 2.0, Health Plans, Hospitals, Policy, The Industry, Transparency | Permalink | Comments (2)

More on Physician Reimbursement, CMS, the AMA's RVS Update Committee (RUC)

by ROY POSES, MD (Note by Brian Klepper: At Health Care Renewal, Dr. Roy Poses, a Clinical Associate Professor at Brown University's School of Medicine, writes a consistently excellent blog on health care financial conflict . Both he and I...
May 12, 2008 in Brian Klepper, Economics, Physicians, Policy/Politics, The Industry | Permalink | Comments (14)

A Hat Tip to Pediatrician Dr. Benjamin Spock

By Brian Klepper Here's one of today's entries in The Writers' Almanac, the wonderful daily newsletter sent out by Garrison Keillor on NPR. Parents of boomers like me were big fans of Dr. Spock, treating him with an almost cult-like...
May 2, 2008 in Brian Klepper, Physicians, Quality | Permalink | Comments (3)

The State of Employer-Sponsored Coverage - Brian Klepper

By Brian Klepper A detailed new study from the Economics Policy Institute confirms what many of us suspect but haven't had the data to easily nail down. This weightily-titled report by Jared Bernstein and Heidi Shierholz - A Decade of...
April 28, 2008 in Brian Klepper, Economics, The Industry | Permalink | Comments (4)

An Open Response To HHS Secretary Mike Leavitt - Brian Klepper and Michael Millenson

By Brian Klepper and Michael Millenson A few months ago, the two of us – both long-time advocates for transparency and accountability – posted separate comments on Secretary Mike Leavitt’s blog. Brian asked Secretary Leavitt to square his support of...
April 22, 2008 in Brian Klepper, Health 2.0, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (0)

Tune Into The Kroll Webcast On The Security of Patient Data - Brian Klepper

By Brian Klepper Exclusive to THCB: A couple weeks ago I pointed to a new study, commissioned by Kroll Fraud Solutions and conducted by HIMSS Analytics, that makes startlingly clear the gap between what most health systems are doing to...
April 22, 2008 in Brian Klepper, Electronic Medical Records, Privacy, The Industry | Permalink | Comments (0)

The Security of Patient Data

By Brian Klepper EXCLUSIVE TO THCB: HIMSS Analytics, the research arm of the powerful, thoughtful and highly regarded Health Information Management Systems Society, has published a sobering study, Security of Patient Data - see here - that highlights the gap...
April 8, 2008 in Brian Klepper, Electronic Medical Records, Health 2.0, Hospitals, Privacy, Technology, The Industry, Web/Tech | Permalink | Comments (3)