The Health Care Blog

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 (2)

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, Physician Rating, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (0)

Which way to go for health reform? From Birkenstocks to pom-poms

By Sarah Arnquist The methods proposed to clean up the health care mess in the United States that leading voices pitched to hundreds of journalists Friday unsurprisingly were as varied as their Birkenstocks and patriotic tie. David Himmelstein, co-founder of...
March 31, 2008 in Policy, Policy/Politics, Quality, Transparency | Permalink | Comments (1)

Dennis Quaid takes on hospital errors

By Sarah Arnquist Hospital patient safety has a new celebrity advocate in Dennis Quaid, whose twin newborns received a massive overdose of a blood thinner last year at Cedars-Sinai Medical Center while being treated for infections. While his twins bled...
March 28, 2008 in Hospitals, Patient Safety, Quality | Permalink | Comments (11)

QUALITY: Medicare Health Support--Done and more or less dusted

Recently the targets on Medicare Health Support were changed to make them more financially favorable to the DM companies running the projects. Everyone inside the DM industry has known that MHS has not been doing too well for some time...
January 31, 2008 in Policy/Politics, Quality | Permalink | Comments (0)

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)

POLICY: Shannon Brownlee is da man!

It's been really great getting to know the new voice of the Dartmouth school, Shannon Brownlee. She's interviewed in her local paper about the concept that the American health care system delivers More money, but less health. Hopefully we'll have...
January 29, 2008 in Policy, Policy/Politics, Quality | Permalink | Comments (3)

QUALITY: Can coughing save your life? Not in Shanghai

So one friend sent me this cool urban legend powerpoint about how coughing saves your life during a heart attack. The About.com page I’ve linked more or less debunks it, but another friend had a much better repost: I ride...
January 29, 2008 in Quality | Permalink | Comments (0)

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)

QUALITY: A nice recommendation from the IOM

Ironically after I spent last week sitting in with the Dartmouth crowd, on Friday the IOM (despite having a lack of Dartmouth folks on this committee!) came out with a recommendation for a New National Program To Evaluate Effectiveness of...
January 28, 2008 in Quality | Permalink | Comments (4)

QUALITY: Decision aids in the real world

Most of this morning at the FIDMD meeting has been largely technical stuff about setting up decision aids. Shannon Brownlee suggests that the name should be changed to “personalized medicine” which has been nicked by the bio-tech crowd for now....
January 25, 2008 in Quality | Permalink | Comments (7)

QUALITY: The sociology & economics of practice patterns & decision aids

More from Matthew at the FIMDM conference David Jones, Harvard medical historian on revascularization Why do you need a randomized clinical trial (RCT)? From the 1960s surgeons could show that CABGs opened veins (removed plaque) so why was there a...
January 25, 2008 in Quality | Permalink | Comments (1)

QUALITY: Last name nepotism? DrGreene on the NY Times

So Indu & I invite Alan Greene and Sarah Greene out to dinner in Utah few months ago. Alan is famed pediatrician from drgreene.com. Sarah runs the NY Times Health page. And now Alan has his own column on parenting...
January 22, 2008 in Quality | Permalink | Comments (2)

QUALITY: Mental health--any ideas?

I was highly struck by something Dr David Sobel said in his great speech at the Ix Therapy conference last October—he suggested some 50% of primary care office visits are the result of background mental health issues. That sounds intuitively...
January 15, 2008 in Quality | Permalink | Comments (7)

QUALITY: CNN's Glen Beck--not a delighted patient

Looks like CNN's Glenn Beck won't say what his local hospital's CEO would like to hear when Press-Ganey call him! He accuses the staff there of not caring. At the hospital I was often treated more like a number than...
January 11, 2008 in Hospitals, Quality | Permalink | Comments (6)

POLITICS: Just Saying No to crass politicization

Yeah, I know it's not likely that anyone will pay attention given the season, but I do feel that there are enough cases with which to bash insurers which are legitimate that John Edwards didn't have to start politicizing one...
January 9, 2008 in Policy, Policy/Politics, Quality | Permalink | Comments (3)

On Practical Reforms - Brian Klepper

Now that health care reform is once again an active, visible issue in state governments and the presidential campaigns, the ideas are flying fast and furious. Predictably, some ideas are better than others. Over at Health Care Policy and Marketplace...
January 9, 2008 in Brian Klepper, Health 2.0, Health Plans, Physicians, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (11)

My Nomination For Health Care Quote of the Year - Brian Klepper

I was reading through other peoples’ blog posts yesterday when amazingly enough, I was here on THCB and came across this straightforward statement by Paul Levy, the CEO of Beth Israel Deaconess Medical Center in Boston. Of course, many readers...
December 22, 2007 in Brian Klepper, Health 2.0, Hospitals, Physicians, Policy, Quality, The Industry, Transparency | Permalink | Comments (6)

POLICY/QUALITY: Uninsurance does indeed kill you quicker

I'm not going to go into the whys and wherefores of what's wrong with cancer care in this country. But when the IOM said that people die early because of uninsurance, people scoffed. The same people (and you know who...
December 20, 2007 in Policy, Quality | Permalink | Comments (2)

Rating Doctors Like Restaurants, by Bob Wachter

Robert Wachter is widely regarded as a leading figure in the modern patient safety movement. Together with Dr. Lee Goldman, he coined the term "hospitalist" in an influential 1996 essay in The New England Journal of Medicine. His most recent...
December 4, 2007 in Bob Wachter, Health 2.0, Quality, Technology | Permalink | Comments (16)

QUALITY: Stents cannot be killed, well perhaps not

So in the latest of the stent wars a new study suggests that Medicare has been saving money as drug-eluting stents have replaced by-passes. This of course is music to the ears of J'n'J & Boston Scientific -- not to...
October 26, 2007 in Quality, Technology | Permalink | Comments (3)

PODCAST: Overtreated--Shannon Brownlee explains all

Overtreated is a marvelous new book by Shannon Brownlee. Shannon is a former US News & World Report health reporter, and now is a Fellow at the New America Foundation (that's the centrist third way Clintonite Dem one). In the...
October 18, 2007 in Policy, Quality | Permalink | Comments (3)

QUALITY/FUNNY: Probably not a major concern in iatrogenic death over here!

Snake in Hospital Gurney Kills Thai Man
September 11, 2007 in Quality | Permalink | Comments (1)

Another Step Toward Transparency -- Brian Klepper

It was the great economist Adam Smith who said that, for markets to work, they need (among other things) "perfect information." Health care hasn't worked, in large measure, because its markets have had almost no information. So in what could...
August 27, 2007 in Quality | Permalink | Comments (4)

PHARMA/QUALITY: Merrill Goozner has dug into "The Most Costly Earmark in S-CHIP"

GoozNews: The Most Costly Earmark in S-CHIP Increased risk of death. No benefit. Higher costs for taxpayers. The ongoing Epo saga, whose latest chapter is being written on Capitol Hill, is a perfect example of why our health care outcomes...
August 27, 2007 in Pharma, Quality | Permalink | Comments (1)

Evaluating the Quality of Quality Improvement Claims: The Population Health Impact Institute - Brian Klepper

Thomas Wilson PhD is on a mission that's important to health care. Tom, a respected epidemiologist particularly well-known in disease management circles, founded the Population Health Impact Institute (PHII), a not-for-profit devoted to establishing clear, objective rules to evaluate claims...
August 24, 2007 in Brian Klepper, Quality, THCB, The Industry | Permalink | Comments (2)

Benign Neglect and the Nursing Shortage - Brian Klepper

I sit on the Dean's Advisory Councils of the Colleges of Health at two public universities in Florida. Both Colleges are led by extremely capable PhD nurses, and have a variety of programs that train students to be health professionals,...
August 21, 2007 in Brian Klepper, Policy, Quality | Permalink | Comments (31)

OMNI: The Oncology Metrics National Index - Brian Klepper

An innovative Ft. Worth consulting firm comprised of experienced oncology professionals, Oncology Metrics, has linked private oncology practices throughout the country in a collaborative, knowledge-sharing enterprise, called the Oncology Circle. The first round of information brought together 22 practices containing...
August 20, 2007 in Brian Klepper, Pharma, Physicians, Quality, Technology, Web/Tech | Permalink | Comments (5)

Can We Talk, Frankly? - Brian Klepper

Over at The Doctor Weighs In, Bill Bestermann literally grabs our attention and forces feeds us a highly informative, and, dare I say, USEFUL physiology lesson in If You Want To Get It Up - You've Got To Get It...
August 17, 2007 in Blogs, Brian Klepper, Physicians, Quality, THCB | Permalink | Comments (0)

Consultants to Hospitals: Prepare for Transparency - Brian Klepper

We must view and treat the community as the "owner" to whom we are fully accountable. Aggregate financial performance data, aggregate productivity performance and aggregate quality and patient satisfaction data belong in the public realm. How else can consumers make...
August 16, 2007 in Brian Klepper, Health Plans, Hospitals, Physicians, Policy, Policy/Politics, Quality, The Industry | Permalink | Comments (4)

Podcast: Mello on Health Courts

Professor Michele Mello, an expert on the health care justice system at the Harvard School of Public Health, has an interesting 9.5 minute audio podcast on why health courts would be an improvement over the current medical liability system. The...
August 16, 2007 in Brian Klepper, Hospitals, Policy, Policy/Politics, Quality, The Industry | Permalink | Comments (0)

Managed Care Redux - by Brian Klepper

Like democracy, managed care is a great idea. It's just that its rarely been tried. Even so, my guess is that its about to re-emerge in a new, improved form, and possibly with some other name. If the signs around...
August 15, 2007 in Brian Klepper, Health Plans, Hospitals, Physicians, Policy, Policy/Politics, Quality, THCB, The Industry | Permalink | Comments (7)

QUALITY/POLICY: Sicko, Deloitte and the reason for EBM

The Deloitte Center for Health Care is best known for being headed by Paul Keckley, recently of the Center for Evidence Based Medicine at Vanderbilt, and a minor actor in Michael Moore's recent spat with CNN. (CNN didn't come clean...
August 8, 2007 in Policy, Quality | Permalink | Comments (0)

PODCAST/QUALITY/TECH/HEALTH PLANS: Disease management, technolgy and the future of health care--Gordon Norman tells all

Gordon Norman is Exec VP and Chief Science Officer at Alere Medical, formerly head of DM at Pacificare and a font of knowledge and opinion about disease management, technology, the role of health plans, and the chances for overall change...
August 6, 2007 in Health Plans, Podcasts, Quality, Technology | Permalink | Comments (1)

QUALITY/POLICY: Medpundit right on on cancer treatment

I didn’t get around to talking about the cancer treatment article in the NY Times last weekend, but Syd at Medpundit did. And I agree with her—we should be figuring out when to say no, heartbreaking though it is. Although...
August 3, 2007 in Policy, Quality | Permalink | Comments (0)

QUALITY/INTERNATIONAL: A great check list and more about EBM

Humphrey Taylor from Harris mentioned to me earlier this year that one thing Americans don’t realize is how much other health care systems are changing—while ours seems stuck in 1987. One case in major point is the UK where serious...
July 25, 2007 in International, Quality | Permalink | Comments (5)

QUALITY: So I switch to diet 7-Up and Splenda, and what do I get?

No difference in my on-rushing likelihood of heart disease--according to the latest iteration of the Framingham study—the long running study of 9,000 patients in Massachusetts. Might as well go back to the chocolate malts….
July 24, 2007 in Quality | Permalink | Comments (2)

HEALTH PLANS/QUALITY: Klepper on the transparency conundrum

Over at The Doctor Weighs In Brian Klepper talks about the transparency conundrum. Should We Have Health Care Performance Transparency? By Whom? And How?. Should transparency be left in the hands of untrustworthy health plans with their own proprietary techniques?...
July 20, 2007 in Health Plans, Quality | Permalink | Comments (0)

HOSPITALS/QUALITY: Virginia Mason--living in the future before it gets here.

More proof that the Michael Porter-type solution is living in the future before it gets here. Another study, this one from HSC shows that Virginia Mason has improved its processes, is saving money for its customers, and is paying the...
July 11, 2007 in Hospitals, Quality | Permalink | Comments (8)

POLICY/QUALITY: Klepper on cabbages and Kings (or Congress)

Brian Klepper, who's traitorously now pimping himself out on other blogs, extends the post I wrote the other day on the CBO at Pat Salber's blog The Doctor Weighs In. It's called Mr. Orszag's Surprise and it's a very good...
July 6, 2007 in Policy, Quality | Permalink | Comments (0)

QUALITY: Back surgery request

A great friend of mine is looking for back surgery information. As we know this is one area where not much is know about what works. Any ideas? If so please comment: I've been dealing with a couple of herniated...
June 27, 2007 in Quality | Permalink | Comments (10)

PHARMA/PHYSICIANS/HOSPITALS/QUALITY: Busy busy busy

My correspondents have sent me lots of articles today. All worth a read— When Is a Pain Doctor a Drug Pusher? Basically never as far as I can tell but in the DEA’s view any time the DEA feels that...
June 22, 2007 in Hospitals, Pharma, Physicians, Quality | Permalink | Comments (6)

QUALITY/POLICYThe NY Times has licked its sore all better!

The New York Times is suddenly acting like Alain Enthoven and Jack Wennberg have taken over its health care reporting! This is the third article saying sensible things about the health care system in less than a week! Today, following...
June 14, 2007 in Policy, Quality | Permalink | Comments (0)

QUALITY/CONSUMERS: Spine site

Given the interest of many of you in back pain, this site looks pretty interesting. Spine-health.com.
June 12, 2007 in Consumers, Quality | Permalink | Comments (0)

TECH/QUALITY: Are Employers the Future Leaders in Chronic Care Management

My article in Digital Healthcare & Productivity about the NYC meeting about remote monitoring and chronic care management is called Are Employers the Future Leaders in Chronic Care Management? As you may know I’m not that optimistic about the role...
May 15, 2007 in Quality, Technology | Permalink | Comments (0)

CONSUMERS/QUALITY: HealthGrades awarded $3.6m from Hewitt

This is a weird one. Quality ratings company HealthGrades has been awarded $3.6m in a breach of agreement from benefits consulting giant Hewitt. Was Hewitt going to use Healthgrades ratings and then decided that no one cared? Anyone got any...
May 7, 2007 in Consumers, Quality, The Industry | Permalink | Comments (0)

TECH/CONSUMERS: Quality, Cost and Connected Health by Joseph Kvedar

Joseph C. Kvedar, MD is the Director of the Center for Connected Health at Partners Healthcare System in Boston. Given that so many organizations are talking about Connected Health in one flavor or another, I thought it might be interesting...
April 19, 2007 in Consumers, Quality, Technology | Permalink | Comments (6)

PODCAST/PHYSICIANS/QUALITY: Interview with David Seligman, CEO of Best Doctors

Here’s the transcript of the interview earlier this week with David Seligman, CEO of Best Doctors. Pretty interesting especially for those of you thinking about how to improve health care quality on a national and perhaps nationally branded level. (By...
April 12, 2007 in Physicians, Podcasts, Quality | Permalink | Comments (4)

PODCAST/PHYSICIANS/QUALITY: Interview with David Seligman, CEO of Best Doctors

This is an interesting podcast (well aren't they all?). I interviewed the CEO of Best Doctors, David Seligman, about his network of second opinion providers and a whole lot more. They're having quite a bit of success selling the service,...
April 10, 2007 in Physicians, Podcasts, Quality | Permalink | Comments (0)

TECH/QUALITY: Stents--it's even worse than we thought, WITH UPDATE from The Industry Veteran

Note: I put this up late last night--but it's such a huge story (and as one emailer says, can you think of a recent study that so blatantly points out all the flaws in the health care industry better than...
March 27, 2007 in Quality, Technology | Permalink | Comments (4)

QUALITY: Plantar warts, duct tape and the real cure

David Williams at Health Business Blog pokes some fun at some investigators looking into a cure for plantar warts who used the wrong type of duct tape in trying to figure out if this cure works. (He calls it File...
March 26, 2007 in Quality | Permalink | Comments (1)

PHYSICIANS/TECH/QUALITY: Tuesday's ACC report will hurt the stent market

The NY Times has an article about how stents are likely to be found to be less useful than would be indicated by the amount of use they get from cardiologists. More bad news for JNJ and BSX, but something...
March 25, 2007 in Physicians, Quality, Technology | Permalink | Comments (1)

HOSPITALS/POLICY/QUALITY: Harvard Business Professor #2 doesn't understand economics

Today, following yesterdays lashing out at Reggie, the next Harvard Prof who's been teeing me off is Michael Porter (and his Virginia colleague Elizabeth Teisberg). I'd been meaning to comment on Michael Porter's latest piece in JAMA (not that I...
March 20, 2007 in Hospitals, Policy, Quality | Permalink | Comments (15)

HEALTH PLANS/QUALITY: Setting up high performance networks leads to lots of trouble

Hmm…mistakes in health care data? Who’d have imagined that. Which leads to lots of politics in the setting up and creation of these “high-performing networks” and of course the ability for the baby of improvement to be thrown out with...
March 19, 2007 in Health Plans, Quality | Permalink | Comments (0)

POLICY/QUALITY/HOSPITALS: Keynsian reporting trumps Smith-ian invisibilty

Michael Cannon at Cato picks up on David Leonhardt's NYT article about error/process reporting in hospitals and suggests that there's no need for regulation, as the market is getting us there already. Hmm… methinks Michael underestimates what one economist he...
March 7, 2007 in Hospitals, Policy, Quality | Permalink | Comments (1)

POLICY/QUALITY: Why does Health Care in the USA cost so much? Over-utilization is an important factor by Walter Bradley

Walter Bradley has not only written the shorter piece today, but has sent me a longer piece citing over-utilization as a cause of high health care costs in the US. I'm inclined to agree with him even if Anderson doesn't....
March 6, 2007 in Policy, Quality | Permalink | Comments (1)

PODCAST/CONSUMERS/TECH: HealthFacts

BCBS of Minnesota has set up an interesting approach to transparency and measuring provider performance. They've created a site called HealthCareFacts.org for consumers to look at and compare provider details, set up a subsidiary called Consumer Aware to run it,...
March 6, 2007 in Consumers, Health Plans, Podcasts, Quality, Technology | Permalink | Comments (1)

CONSUMERS/QUALITY: LASIK--not as user friendly as it's supposed to be

There's been lots of BS about how the price reductions in those ads for LASIK "prove" that cash based consumer payment works in health care. I always thought they were like the teaser prices in travel adverts in the Sunday...
February 16, 2007 in Consumers, Quality | Permalink | Comments (3)

PODCAST/TECH/QUALITY: MedEncentive--can a simply "elegant" solution really change health care delivery?

Jeff Greene believes that his "elegant" solution can change health care delivery in one of the toughest places in America to do it--the wild medical mid-west. Jeff claims that the only two places on earth where life expectancy is falling...
February 13, 2007 in Podcasts, Quality, Technology | Permalink | Comments (1)

QUALITY/INTERNATIONAL: More confusing international comparisons

I don’t know much about medical care, but I do remember that in Lynn Payer’s Medicine and Culture the most amusing factoid was that German doctors put people whose blood pressure was too low on medication to raise it. Does...
January 24, 2007 in International, Quality | Permalink | Comments (0)

QUALITY/TECH: A nice conversation with Brent James

This is possibly the most interesting podcast yet on THCB. And it's certainly the longest. if you didn't have the time to listen to the interview with Brent James, here's the transcript. I really recommend this one--there are so many...
January 22, 2007 in Quality, Technology | Permalink | Comments (6)

CONSUMERS/QUALITY: A DIY Approach to the Diabetes Epidemic by Amy Tenderich

#1 health care blogger, well actually #1 patient blogger, but probably the most important one in the whole medical blogosphere, Amy Tenderich has written a book called called Know Your Numbers, Outlive Your Diabetes about (obviously) how to manage diabetes....
January 15, 2007 in Consumers, Quality | Permalink | Comments (10)

QUALITY: All is not well in the DM world

Last year LifeMasters pulled out of one of the Medical Health Support DM pilots in rural Oklahoma because they found that adhering to the proper standards of care made the cost of care go up for those patients they enrolled,...
January 9, 2007 in Quality | Permalink | Comments (1)

QUALITY/POLICY: Gerald Ford--the poster child for what's wrong with health care

Gerald Ford died last night aged 93. By any standards he had a great life. He was a moderate Republican in the House for many years, and then a stop-gap President after Nixon, famous mostly for pardoning Nixon who hadn’t...
December 27, 2006 in Policy, Quality | Permalink | Comments (23)

PODCAST/QUALITY/TECH: An hour with Brent James

This was a total pleasure. Yesterday I got to spend an hour talking with Dr. Brent James, one of the leaders in the patient safety movement, instituting process change in health care, and the man responsible in large part for...
December 22, 2006 in Podcasts, Quality, Technology | Permalink | Comments (1)

PHARMA/POLICY/QUALITY: Cost-effectiveness in drug approval

I’ve been hanging with the libertarian Canada-bashers from PRI! They and the California Health Institute (the Cal biotech and drug company industry group) invited me to a very, very nice dinner last night. I assume that they used the drug...
December 18, 2006 in Pharma, Policy, Quality | Permalink | Comments (0)

QUALITY/POLICY/TECH: Quick notes from the road

Apologies to those who’ve missed me. I’ve been lost in the mid-west taking part in some scenario planning about the big picture future of health care. I can’t give you any details (at least not yet) but it did involve...
November 30, 2006 in Policy, Quality, Technology | Permalink | Comments (2)

QUALITY: The herniated disk story

Medpundit has a pretty good explanation of the recent study about herniated disk surgery. Basically it works, but if you wait two years, then the results are about the same as non-surgical treatment—roughly 70% of people get better, and there...
November 27, 2006 in Quality | Permalink | Comments (10)

TECH/HEALTH PLANS/QUALITY: Lonny Reisman, Active Health Management transcript

Here’s the transcript from the podcast I did with Lonny Reisman, a week or so back. Really interesting stuff for those of you interested in the future of patient care management. Matthew Holt: So welcome to another forecast here at...
November 22, 2006 in Health Plans, Quality, Technology | Permalink | Comments (5)

TECH/QUALITY: Reason why health care costs keep exploding, #469

The number of CT studies is growing at 8% annually.
November 10, 2006 in Quality, Technology | Permalink | Comments (8)

QUALITY/PHYSICIANS: OBGYNs are scientists, scientists I tell you

Interesting long article in the New Yorker by Atul Gawande about How childbirth went industrial. Briefly it’s about how we stopped using all kinds of techniques for getting kids out that required a lot of skill because we started measuring...
November 9, 2006 in Physicians, Quality | Permalink | Comments (2)

PODCAST/TECH/QUALITY: Don Kemper podcast

Here’s the transcript from the recent podcast with Don Kemper. Interesting stuff from a real pioneer. Matthew Holt: So welcome to another THCB podcast. Today we're very lucky to have Don Kemper, who is the President, CEO and certainly the...
November 7, 2006 in Podcasts, Quality, Technology | Permalink | Comments (1)

TECH/QUALITY/THE INDUSTRY/HOSPTIALS: Transforming patient care, with UPDATE

Cisco has produced a video on transforming patient care which includes discussion from “Crossing the Chasm” author Geoffrey Moore, Jeff Rideout, Cisco’s head honcho Medical Director, several hospitals execs, and a cameo from me. Go to this site to register...
November 2, 2006 in Hospitals, Quality, Technology, The Industry | Permalink | Comments (0)

BLOGS/TECH/QUALITY: HealthTrain, the Open Healthcare Manifesto

Yesterday saw the official launch of HealthTrain, the Open Healthcare Manifesto. Dmitriy Kruglyak has been working on this for some time with a large group of collaborators, and I have joined several others to sign on. The manifesto lays down...
October 31, 2006 in Blogs, Quality, Technology | Permalink | Comments (3)

QUALITY: Does DM save money? The old chestnut rears its ugly head

Poor Chris Selecky of Lifemasters. I had a brief chat with her at a DM conference in August and she was heading to the beach (happily) after selling the company to Healthways. Or so she thought. But then that merger...
October 30, 2006 in Quality | Permalink | Comments (5)

QUALITY/TECH/PODCAST: Interview with Don Kemper, CEO of Healthwise

Don Kemper from HealthWise essentially invented the concept of information therapy--the idea that every contact between patients and the medical system should come with an actual prescription for information. I think it's an incredibly important concept, so I talked with...
October 30, 2006 in Podcasts, Policy, Quality | Permalink | Comments (0)

TECH: The best treatments for heart disease?

I’d never heard of EECP as a treatment for heart disease. Apparently it works, according to this UCSF analysis. But Debra Braverman’s letter to the NY Times says it all (other than mistaking the drug industry for the medical device...
October 30, 2006 in Policy, Quality, Technology | Permalink | Comments (3)

QUALITY/POLICY: The Scourge of Skid Row

This is very, very unpleasant. A staph infection outbreak in Los Angeles that’s got its own name— the Scourge of Skid Row. And it’s one reason why public health, including the real basics like housing, clean water and access to...
October 20, 2006 in Policy, Quality | Permalink | Comments (0)

QUALITY/THE INDUSTRY: DM powerhouse nixed by spreadsheet error

First the merger was delayed for some vague reason. Now it’s off. LifeMasters and Healthways nix $307M merger basically because of over-reported value of a certain contract — presumably one of the larger ones, and my guess would be a...
October 2, 2006 in Quality, The Industry | Permalink | Comments (0)

QUALITY/POLICY: Futurist's forecast from Clem Bezold

Clem Bezold from Institute for Alternative Futures (kind of the alternative IFTF) gave an overview of the conference and an optimistic 2016 forecast for the availability of broadband to the home, better knowledge and personalized tools that will work on...
September 27, 2006 in Policy, Policy/Politics, Quality | Permalink | Comments (0)

TECH/QUALITY: More quick hits from Ix conference

Deborah Bell—Runs ovarian cancer listserv and became an in-depth patient Alan Greene, the pediatrician who runs DrGreene.com, and gets 50 million hits a month from 2 million unique users—Money quote for doctors online and off - “You have to get...
September 26, 2006 in Quality, Technology | Permalink | Comments (0)

QUALITY: DM on Medicare Health Support, and a nice award

Next up at the Ix conference, Medicare Health Support got three cheerleaders telling us that they’re doing very, very well (Sandy Foote ex CMS, George Bennet from Health Dialog, Michael Montijo from American Healthways. There;s lots and lots of details...
September 26, 2006 in Quality, Technology | Permalink | Comments (0)

QUALITY/CONSUMERS: Wallace and some patient advocates

Information Therapy center chair Paul Wallace is from Kaiser Permanente, who quite logically would be interested in Ix. He notes that the medical care cost, and the costs of poor health to employers far exceed the medical cost. (Absenteeism. etc)...
September 25, 2006 in Consumers, Quality | Permalink | Comments (1)

QUALITY/POLICY: Information Therapy conference, the employer coalition view

So as I warned you, I’m at the Information Therapy conference in Park City, Utah. Andrew Webber from National Business Coalition on Health. Tries to come at Information Therapy from the point of view of an employer—but an employer who...
September 25, 2006 in Quality | Permalink | Comments (0)

QUALITY: 2006 Information Therapy Conference

The 2006 Information Therapy Conference starts later today in lovely Park City, Utah. I may post a photo or two from my weekend in the lovely southern part of the state, and I’ll be giving more information about what’s going...
September 25, 2006 in Quality | Permalink | Comments (0)

PHYSICIANS/QUALITY: Getting the Cedars-Sinai docs to change behavior

Pretty interesting article from the Freakonomics guys about the large efforts it took to get docs at Cedars Sinai to change a relatively simple behavior with a big impact on patient safety— washing their hands. One gets the impression the...
September 25, 2006 in Physicians, Quality | Permalink | Comments (1)

QUALITY/HOSPITALS: Odd hospital stay ratings--only the good get mentioned?

In a vox populi column the SF Chronicle asked readers, How would you rate your last hospital stay? Funnily enough in every case when they had a good experience they mentioned the name of the hospital. If they had a...
September 18, 2006 in Hospitals, Quality | Permalink | Comments (1)

QUALITY/TECH: Book reviews on quality and technology strategy

So it's time for book reviews on THCB. The first book I will talk about is an excellent business written by -- full disclosure -- my good friend Tony Seba. For several years now Tony has been teaching a course...
August 31, 2006 in Quality, Technology | Permalink | Comments (2)

QUALITY/PHYSICIANS/POLICY/POLITICS: Hmm...."questiions" about those chemo payments

Chemotherapy; Part B "reforms"; bribes to doctors; taxpayer and Medicare patients bilked. Have we heard any of this before? (I’m sure we’ll hear from Greg soon!)
August 30, 2006 in Physicians, Policy, Policy/Politics, Quality | Permalink | Comments (5)

POLICY/THE INDUSTRY/QUALITY: Why health care costs so much, reason #498

Two angioplasty procedures on a 93 year old in one week. Former President Ford underwent his second heart procedure in a week at the Mayo Clinic when stents were placed into two of his coronary arteries to increase blood flow,...
August 28, 2006 in Policy, Policy/Politics, Quality, The Industry | Permalink | Comments (10)

HEALTH PLANS/QUALITY: BC California on P4P

My erstwhile colleagues at FierceHealthcare have an interview up with Dr. Michael Belman, staff VP and Medical Director, Blue Cross of California. It's a pretty good introduction, for those of you who don't know much about it, to the P4P...
August 28, 2006 in Health Plans, Quality | Permalink | Comments (0)

QUALITY/POLICY/HEALTH PLANS: Cranky, confused, aimless and spineless

And in the all talk and no action department… Ian Morrison and Bob Leitman used to go around America calling employers’ attitude towards buying health care for their employees“cranky, confused, aimless and spineless”….that was in the early 1990s. It’s all...
August 21, 2006 in Health Plans, Policy, Quality | Permalink | Comments (1)

QUALITY: More from the DM conference

More from the DM conference….. Chris Selecky from Lifemasters says that their MHS programs are going well. They’re in Oklahoma as a prime and as a sub to Aetna to Chicago. Hving to do much more comunity based stuff than...
August 2, 2006 in Quality | Permalink | Comments (0)

QUALITY/TECH: Disease Management conference in Boston

Musings from the conference on disease management…..it’s hot in Boston but a few musing from presentations ************ Cheap interventions in DM work. Cutting co-pay costs to close to zero and adding pharmacists doing education for chronically ill people in a...
August 1, 2006 in Quality | Permalink | Comments (6)

QUALIY/PHYSICIANS: P4P in the United Kingdom

The biggest P4P scheme in the world is going on in the UK, one that I first wrote about in early 2004. (For more on the wider ramifications of reform in the UK ,see yet another article in this weeks...
July 27, 2006 in Physicians, Quality | Permalink | Comments (2)

TECH/QUALITY/PHYSICIANS: Healthcare and The Long Tail - Searching for help when you’re on the wrong-end of the curve by Jim Walker

Two things have got my attention recently. The first is the concept of the long tail in medicine, which I've thought about alot since my fiancee got an odd condition (shortness of breath) that didn’t match any of the symptoms...
July 26, 2006 in Physicians, Quality, Technology | Permalink | Comments (5)

QUALITY/CONSUMERS: A really personal piece about obesity

From Pat Salber at The Doctor Weighs In, here's a very personal look at the life of someone extremely obese as a side effect of diabetes . Well worth reading, even if it might spoil your appetite and get you...
July 21, 2006 in Consumers, Quality | Permalink | Comments (1)

QUALITY/PHYSICIANS: Just what we need now, another grandstanding politician on end of life issues

I’ve been having a backchat email with the people from the Tenet Shareholders Committee. They are enjoying the legal attack on the Louisiana physician who is supposed to have performed a mercy killing or provided ample pain medication at Tenet’s...
July 20, 2006 in Physicians, Quality | Permalink | Comments (6)

QUALITY/HOSPITALS: I shouldn't joke about this, but...

....you've got to ask if this is is a case of a fatal nosocomial illness.
July 20, 2006 in Hospitals, Quality | Permalink | Comments (0)

QUALITY: Yogurt--health food or dessert?

At The Doctor Weighs In spoilsport Pat Salber tells you that yogurt is not a health food! As I like (sweetened) yogurt — as oppsed to the natural rubbish — that’s obvious to me. The Matthew Holt test is, if...
July 12, 2006 in Quality | Permalink | Comments (7)

QUALITY/PHYSICIANS: Klein on malpractice

Ezra Klein has written a pretty good state of play about Medical Malpractice over at Slate. As you know I’m all for putting the solution for malpractice within the context of an overall medical error/practice guideline/EBM policy. Of course, politically...
July 11, 2006 in Physicians, Quality | Permalink | Comments (0)

QUALITY/PHARMA: Someone's going to get fired at the DEA for sure

The WSJ writes about a serious scientific study of the hallucinogen in magic mushrooms. As you might expect virtually all of the participants thought that the sessions had a very powerful effect and 60% of the clinical trial participants said...
July 11, 2006 in Pharma, Quality | Permalink | Comments (1)

POLICY/QUALITY: Reclaiming the right to die; book review by Mitchell Berger

Mitchell Berger volunteered to write a review of William Colby’s, Unplugged: Reclaiming Our Right To Die in America (2006, American Management Association, 272 pp., $24.95 hardcover), and an excellent review it is too: High-profile legal cases such as those involving...
July 11, 2006 in Policy, Quality | Permalink | Comments (1)

POLICY/PHYSICIANS: Too many doctors

Dartmouth worthy David Goodman has an op-ed in the NY Times called Too Many Doctors in the House. It makes the arguments that you all know well, but it does contain this lovely zinger. The association of medical colleges has...
July 10, 2006 in Physicians, Quality | Permalink | Comments (3)

QUALITY: Performance measures only have a little of the answer

(Hat-tip to Modern Healthcare for spotting this one). While there was lots of fuss about the IHI 1OOK lives campaign recently and whether it did or didn’t meet its target—and the NY Times gave it a pat on the back...
July 6, 2006 in Quality | Permalink | Comments (16)

QUALITY: Quiet welcome to new sponsor

It’s a quiet return around here from the prolonged July 4th weekend. Meanwhile, there’s a new sponsor at THCB. This time it’s a book called “On Track To Quality” by James Todd, a pediatrician at Children’s Hospital in Denver. The...
July 5, 2006 in Quality | Permalink | Comments (0)

BLOGS/QUALITY: Big themes and signing off from FierceHealthcare

Here’s my last ever FierceHealthcare editorial. The FierceMarkets team is taking the editorializing of FierceHealthcare back in-house and I wish them luck. It’s been fun for me (and John Irvine who’s supported me all the way) to work on this...
June 30, 2006 in Blogs, Quality, THCB | Permalink | Comments (0)

QUALITY/TECH/POLICY: IFTF meeting on the Global Health Economy

I’m at an IFTF meeting on the Global Health Economy. IFTF has gone a little off into left field on the “health” issue since I left. They’re slowly coming back relating “health” back to the health care system (the stuff...
June 28, 2006 in Policy, Quality, Technology | Permalink | Comments (0)

TECH/QUALITY: Buying Guidant still such a great idea?

"We knew, when we did our due diligence, that the [cardiac rhythm management business] of Guidant hadn't had its last recall," Chief Executive Jim Tobin said on a conference call with analysts and investors. He said it will take 18...
June 26, 2006 in Quality, Technology | Permalink | Comments (0)

HOSPITALS/QUALITY: A quiet little speech by Michael Millenson

Millenson on the lack of real committment to patient safety. Acerbic and fantastic. A few quotes, but as they say in the blogosphere read the whole thing If there is a quality crisis today, it certainly is not apparent from...
June 26, 2006 in Hospitals, Quality | Permalink | Comments (3)

QUALITY: Improving health care from within, by Eric Novack

Eric Novack sees hope in the IHI’s 100K lives program which announced impressive results this week, and being Eric, he thinks that there’s a political message in there too. There’ll be more on his show this Sunday. The Institute for...
June 23, 2006 in Quality | Permalink | Comments (3)

QUALITY: Book reviewer?

There’s an article out called “How We Die in America” which is from a new book called UNPLUGGED: Reclaiming our Right to Die in America, by William Colby. The publisher is looking for a reviewer, so if you’re interested in...
June 23, 2006 in Quality | Permalink | Comments (0)

QUALITY/INDUSTRY: Healthways buys Lifemasters

Over in the disease management world, a little piece of consolidation late yesterday. Healthways is buying Lifemasters for some $307m. Healthways is running at a $400m annual revenue rate and has a $1.75 billion market cap, so that suggests that...
May 30, 2006 in Quality, The Industry | Permalink | Comments (2)

QUALITY/CONSUMER/TECH: Health -- On Demand by Pat Salber

Pat Salber writes The Doctor Weighs In, and she has some pretty interesting thoughts about this consumer health schtick. I cross-posted here but go check out her blog too! The Internet has changed the way we do so many of...
May 17, 2006 in Consumers, Quality, Technology | Permalink | Comments (3) | TrackBack

QUALITY: The patient satisfaction trap by John Irvine, with rant from Ann Farrell

So in FierceHealthcare today my colleague John Irvine wrote this Some hospitals have argued for years that patient satisfaction scores can be misleading when it comes to gauging the quality of the healthcare services they receive. After all, patients are...
May 3, 2006 in Quality | Permalink | Comments (2) | TrackBack

QUALITY: Games For Health

There’s a Games for Health Day on May 9 in Los Angeles, California. It’s on the subject of Games for rehab, pain distraction, and health promotion. Want to know more? Games For Health
May 3, 2006 in Quality | Permalink | Comments (0) | TrackBack

QUALITY: Middle-Aged Americans Sicker Than British

Says here that Middle-Aged Americans are Sicker Than British. . Apparently at every class strata it's true: A higher rate of Americans tested positive for diabetes and heart disease than the British. Americans also self-reported more diabetes, heart attacks, strokes,...
May 2, 2006 in Quality | Permalink | Comments (1) | TrackBack

TECH/QUALITY/PHARMA: Active Health used by Mariott

Interesting brief presentation — Mariott uses Active Health Mangement to change its formulary Integrates pharmacy, medical and labs data from one place—inluding diagnosis and runs it against the medical literature based algoritms. They then communicate information to both providers and...
April 18, 2006 in Pharma, Quality, Technology | Permalink | Comments (1)

POLICY/QUALITY: Sliding Down the Back Side of the Health Care Quality Curve: Who's at Greatest Risk?, by Brian Smedley

The recent RAND study that suggested that there were few or no differences in the quality of treament of minorities when they got into the US health system has not been taken lying down by those who believe that there...
March 28, 2006 in Policy, Quality | Permalink | Comments (21)

TECH/QUALITY: Are laproscopes really dangerous?

There's a new crisis every day, and Friday's was a terrible new affliction as reported in the New York Times caused by poorly used laproscopes which burn holes and cause bacterial infections because don't have a special new feature that...
March 20, 2006 in Quality, Technology | Permalink | Comments (2)

POLICY/QUALITY: The intellectual backdrop has been created for P4P

Here’s my FierceHealthcare editorial Last week a study from Wennberg's Dartmouth group showed that there were vast variations in the amount of "physician resources" used to produce similar care outcomes, in that case in intensive care settings. This week a...
March 17, 2006 in Policy, Quality | Permalink | Comments (1)

PHARMA/QUALITY: New York Times discovers compliance

Says here, compliance with drug regimens is a big problem. (Adopt Harry Shearer voice with hard “en” sound in “knew”)” Who knew? Who knew? And McKesson, plus a boat load of other DM, PB