The Health Care Blog

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, reform, 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, reform, 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 (19)

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, reform, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (20)

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, reform, 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, reform, 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, reform, 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, reform, 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, reform, 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 (9)

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, reform, 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, reform, 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 (10)

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, reform | 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, reform, 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, reform, 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)

Knowledge Like Clear, Clean Water: Muir Gray on Health Care's Progress

By Brian Klepper Over the last year or so, I've written a lot about how health care information will become increasingly available to consumers and health care business, and how this access will drive new decision-support capabilities that will profoundly...
April 7, 2008 in Brian Klepper, Health 2.0, The Industry, Transparency | Permalink | Comments (4)

Health Wonk Review - 4/3/08

By Brian Klepper HWR has clearly arrived, at least in the sense that all KINDS of columnists are clamoring to be read here. More than thirty submissions arrived in my inbox, a collection of the utilitarian, the thoughtful and sometimes...
April 3, 2008 in Around the Web, Brian Klepper | Permalink | Comments (4)

On Corporate Medicine: A Response To Brian Klepper, and His Reply - Maggie Mahar

Maggie Mahar, the former Barron's journalist, author of Money Driven Medicine, and Health Policy Fellow at The Century Foundation and frequent THCB contributor chewed on my piece about Walgreen's recent acquisition of worksite clinic firms, and wrote a strong response...
April 2, 2008 in Brian Klepper, Economics, Maggie Mahar | Permalink | Comments (18)

Rebuilding The Medical Home: What Walgreens Surely Sees

By Brian Klepper Though it probably went mostly unnoticed in the cacophony of health care stories, last week's news that Walgreen's had bought the two largest and most well-established worksite clinic firms, iTrax and Whole Health Management, was a harbinger...
March 27, 2008 in Brian Klepper, Health 2.0, Health Plans, Physicians, The Industry | Permalink | Comments (11)

Loving Our Children

By Brian Klepper Among its many less-noticed accomplishments, this Administration has strangled funding for comprehensive sex education. Instead, it has thrown the immense weight of the US government behind abstinence-based education, an impractical ideological approach rooted in religious zealotry and...
March 14, 2008 in Brian Klepper, Patient Safety, Policy, Policy/Politics, The Industry | Permalink | Comments (1)

The Myth of Health Care Consumerism

By Brian Klepper Last weekend I heard several great presentations at a meeting convened by Jeff Goldsmith, but one contained a point I hadn't heard nailed down before. Kaveh Safavi MD JD, from Thomson Healthcare's Center for Healthcare Improvement, detailed...
March 13, 2008 in Brian Klepper, Economics, Health 2.0, Policy, Policy/Politics, The Industry, Transparency | Permalink | Comments (23)

Healthcare and The Gathering Storm - Brian Klepper

Here are two very interesting and frightening charts that my good friend Warren Brennan, the CEO of SMA Informatics in Richmond, passed along this AM, with this question, aimed at the CFOs of hospitals and other health care organizations: What...
February 29, 2008 in Brian Klepper, The Industry | Permalink | Comments (7)

Let's All Ask Secretary Leavitt To Explain HHS' Schizophrenia On Medicare Physician Data - Brian Klepper

Regular readers will know that, last Sunday, I posted a column that pointed to HHS' schizophrenic behavior when it comes to the release of Medicare physician data. First they fight the consumer advocacy group Checkbook.org's lawsuit demanding the release of...
February 13, 2008 in Brian Klepper, Physicians, Policy, Policy/Politics, The Industry, Transparency | Permalink | Comments (2)

Sunday Morning Post, by Brian Klepper

Here's a classical example of a federal regulatory agency holding fast to two opposing ideas at the same time. I wonder what it means? Last week the Department of Health and Human Services posted an interesting notice announcing a new...
February 10, 2008 in Brian Klepper, Physicians, Policy, Policy/Politics | Permalink | Comments (1)

POLICY: Plumpy'nut - Brian

The NY Times ran an important op-ed yesterday by Susan Shepherd, a pediatrician and medical advisor to Doctors Without Borders. The core of her message is that as the farm bill progresses through Congress, we should focus not only on...
January 30, 2008 in Brian Klepper, Quality | Permalink | Comments (1)

Families USA Health Action 2008: An Alternative Plan - Brian

A wonderful meeting (Full disclosure: They brought me in to blog my impressions.), The Families USA conference that ended Saturday brought together some impressive Congressional politicians - Nancy Pelosi, Tom Daschle, Ken Salazar, Blanche Lincoln - and true health care...
January 28, 2008 in Brian Klepper, Policy, Policy/Politics, The Industry | Permalink | Comments (2)

Families USA Health Action 2008: Berwick on Everything Health Care - Brian

One of the pleasures of the Families USA Health Action conference was that the speakers represented a nice blend of top politicians and genuine health care experts. Tony Fauci MD, the wonderful head of NIH's National Institutes for Allergies and...
January 28, 2008 in Brian Klepper, Policy, Quality, The Industry | Permalink | Comments (1)