Pertinent news and analysis of the acute care to consumer continuum emphasizing the ACO, HIE and medical home (PCMH) models and information technology.
21
Continued Information Advantage Group, San Francisco, IAG.co, 415.346.3860 Summer 2011-July Information Advantage Group’s Healthcare Digest is focused on the emerging delivery models and tools for the hospital-to-consumer continuum. In a fast-read format, we provide only the vital news that is essential to keeping you current on the latest and most notable trends, ideas, research, results, technological developments and helpful resources. Click on titles below for quick navigation, once there, click on abstract title to go to source. MACRO TRENDS • Q1 GDP ADJUSTED UP…SLIGHTLY • CONSUMER AND BUSINESS CONFIDENCE SLIPS • BY FAR, MAJORITY OF AMERICANS ARE STILL HAPPY • MARKETERS CAN MISS THE LARGEST PERCENTAGE OF BUYERS • A SHIFT TO THE RIGHT – THE MAJORITY (52%) OF SOCIAL NETWORK USERS ARE 36+, YOUNGER SHOWS STEEP DECLINE HEALTHCARE MACROS • IDC STUDY: HEALTHCARE IS THE MOST ATTRACTIVE US MARKET • HOSPITAL SERVICES COST CONTINUES TO RISE YEAR OVER YEAR • $8,100 PER MAN, WOMAN AND CHILD IN 2009 • MOST HOSPITALS PREPARING FOR THINNER MARGINS • AHIP COUNTERS AMA CHARGES • MCKINSEY QUARTERLY: EMPLOYERS WILL PUSH TO DROP TRADITIONAL COVERAGE • EXPECT EMPLOYER-BASED RETIREMENT PLANS TO BE RETOOLED • HEALTH SAVINGS ACCOUNTS GROW 14% • EMPLOYERS WILL INVEST MORE IN WELLNESS/FITNESS PROGRAMS • THE NEXT GENERATION OF MOBILE APPS TO OFFER “VIDEO HOUSE CALLS” • WORLDWIDE MOBILE HEALTH PROJECTS – EARLY DAYS, RELATIVELY LOW TECH • MINNESOTA PIONEERS ALLIED HEALTH WORKFORCE EXPANSION ACO • EARLY FEDERAL ACO PILOTS FALL SHORT ON RETURN AND COSTS • CALIFORNIA HYBRID ACO PARTNERSHIP SHOWS $15.5 MILLION IN SAVINGS • KPMG SURVEY: MOST PROVIDERS ARE STILL THINKING ABOUT AN ACO, MOST PAYERS DON’T HAVE A STANCE • HFMA: 12 ESSENTIALS FOR ACO SUCCESS REPORT • PHYSICIAN ALIGNMENT IS THE MOST CRITICAL STEP FOR DEVELOPING AN ACO • TOP FIVE: ALIGNING PHYSICIANS FOR THE ACO • DOJ SAYS MOST ACOS WON’T HAVE ANTITRUST PROBLEMS • NEWLY RELEASED - CMS ACO HELPFUL RESOURCES MEDICAL HOME • FIRST ONCOLOGY MEDICAL HOME REDUCES HOSPITALIZATIONS • ONLY 35% OF UNDER 20 PHYSICIAN PRACTICES USE MEDICAL HOME PROCEDURES • COORDINATION OF CARE IMPROVES WITH EHR • NEWLY RELEASED - HELPFUL RESOURCES: HIE • THE AMERICAN ASSOCIATION FOR FAMILY PRACTICE LAUNCHES LOW-COST MESSAGING SERVICE (HIE) • MAINE PASSES OP-OUT HIE REQUIREMENT • LESSONS LEARNED FROM CONNECTING TO THE NATIONWIDE HEALTH INFORMATION NETWORK (NWHIN) • NEWLY RELEASED - HIE HELPFUL RESOURCES: PHYSICIAN & PROFESSIONALS • PATIENT EXPERIENCE – A LONG LIST OF “ROOM FOR IMPROVEMENT” IN THE TYPICAL OFFICE VISIT • BETTER PHYSICIAN-TO-PATIENT COMMUNICATIONS IS THE KEY TO IMPROVING PERCEIVED QUALITY • CANADIAN PHYSICIANS RECEPTIVE TO PHR…WITH THE USUAL CONCERNS • VA PHYSICIANS STILL USE WORK-A-ROUNDS WITH EHR • 19% OF PHYSICIAN USING TABLETS CLINICALLY • PATIENT LIKE IPAD EDUCATION VIDEOS PATIENT-CONSUMER -CAREGIVER • PWC: CONSUMERS WILL SPEND $13.8 BILLION OF THEIR OWN MONEY • CONSUMERS WILLING TO PAY FOR NEW GENERATION OF HEALTH DEVICES • MEDICAID PRICE CONTROLS LIMITS CHILDREN GETTING CARE • YOUNG CANCER PATIENTS SPEND ALMOST FOUR TIMES AS MUCH AS THOSE WITH OTHER CHRONIC CONDITIONS • NEWLY RELEASED - PATIENT-CONSUMER-CAREGIVER HELPFUL RESOURCES • BOOMERS NEED EDUCATION ON HOW TO CARE FOR THEIR PARENTS OVERSIGHT -INFLUENCE -INNOVATION • REGULATORY:
Transcript
1. S u mme r 2 01 1 -Ju lyInformation Advantage Groups
Healthcare Digest is focused on the emerging delivery models
andtools for the hospital-to-consumer continuum. In a fast-read
format, we provide only the vital newsthat is essential to keeping
you current on the latest and most notable trends, ideas,
research,results, technological developments and helpful resources.
Click on titles below for quick navigation, once there, click on
abstract title to go to source.MACRO TRENDS Q1 GDP A DJUSTED U
PSLIGHTLY MEDICAL HOME CONSUMER AND B USINESS CONFIDENCE SLIPS
FIRST ONCOLOGY MEDICAL HOME REDUCES BY FAR, MAJORITY OF A MERICANS
ARE STILL HAPPY HOSPITALIZATIONS MARKETERS CAN MISS THE LARGEST P
ERCENTAGE OF ONLY 35% OF UNDER 20 PHYSICIAN PRACTICES USE BUYERS
MEDICAL HOME PROCEDURES A SHIFT TO THE RIGHT THE MAJORITY (52%) OF
COORDINATION OF CARE I MPROVES WITH EHR SOCIAL NETWORK USERS ARE
36+, YOUNGER SHOWS NEWLY RELEASED - HELPFUL R ESOURCES: STEEP
DECLINE HIEHEALTHCARE MACROS THE AMERICAN ASSOCIATION FOR FAMILY
PRACTICE IDC STUDY: H EALTHCARE IS THE MOST ATTRACTIVE LAUNCHES
LOW-COST MESSAGING SERVICE (HIE) US MARKET MAINE PASSES OP-OUT HIE
R EQUIREMENT HOSPITAL SERVICES COST CONTINUES TO RISE YEAR LESSONS
LEARNED FROM CONNECTING TO OVER YEAR THE NATIONWIDE HEALTH
INFORMATION NETWORK $8,100 PER MAN, WOMAN AND CHILD IN 2009 (NWHIN)
MOST HOSPITALS PREPARING FOR THINNER MARGINS NEWLY RELEASED - HIE
HELPFUL RESOURCES: AHIP COUNTERS AMA CHARGES MCKINSEY QUARTERLY: E
MPLOYERS WILL PUSH TO PHYSICIAN & PROFESSIONALS DROP
TRADITIONAL COVERAGE PATIENT EXPERIENCE A LONG LIST OF ROOM FOR
EXPECT E MPLOYER-BASED R ETIREMENT PLANS TO BE IMPROVEMENT IN THE
TYPICAL OFFICE VISIT RETOOLED BETTER PHYSICIAN-TO-PATIENT
COMMUNICATIONS IS HEALTH SAVINGS ACCOUNTS GROW 14% THE KEY TO
IMPROVING P ERCEIVED Q UALITY EMPLOYERS WILL INVEST MORE IN
WELLNESS/FITNESS CANADIAN PHYSICIANS RECEPTIVE TO PHRWITH THE
PROGRAMS USUAL CONCERNS THE NEXT GENERATION OF MOBILE APPS TO OFFER
VA PHYSICIANS STILL USE WORK-A-ROUNDS WITH VIDEO HOUSE CALLS EHR
WORLDWIDE MOBILE HEALTH PROJECTS EARLY 19% OF PHYSICIAN USING
TABLETS CLINICALLY DAYS, RELATIVELY LOW T ECH PATIENT LIKE I PAD
EDUCATION VIDEOS MINNESOTA PIONEERS ALLIED HEALTH WORKFORCE
EXPANSION PATIENT-CONSUMER -CAREGIVER PWC: CONSUMERS WILL SPEND
$13.8 BILLION OFACO THEIR OWN MONEY EARLY F EDERAL ACO PILOTS FALL
SHORT ON RETURN CONSUMERS WILLING TO PAY FOR NEW GENERATION AND
COSTS OF HEALTH DEVICES CALIFORNIA HYBRID ACO PARTNERSHIP SHOWS
$15.5 MEDICAID PRICE CONTROLS LIMITS CHILDREN MILLION IN SAVINGS
GETTING CARE KPMG SURVEY: MOST P ROVIDERS A RE STILL YOUNG CANCER
PATIENTS SPEND A LMOST FOUR TIMES THINKING ABOUT AN ACO, MOST
PAYERS DON T HAVE AS MUCH AS THOSE WITH OTHER CHRONIC A STANCE
CONDITIONS HFMA: 12 ESSENTIALS FOR ACO SUCCESS REPORT NEWLY
RELEASED - PATIENT-CONSUMER-CAREGIVER PHYSICIAN ALIGNMENT IS THE
MOST CRITICAL STEP HELPFUL RESOURCES FOR DEVELOPING AN ACO BOOMERS
N EED E DUCATION ON HOW TO CARE FOR TOP FIVE: ALIGNING PHYSICIANS
FOR THE ACO THEIR PARENTS DOJ SAYS MOST ACOS WONT HAVE ANTITRUST
PROBLEMS OVERSIGHT -INFLUENCE -INNOVATION REGULATORY: NEWLY
RELEASED - CMS ACO HELPFUL R ESOURCES Continued Information
Advantage Group, San Francisco, IAG.co, 415.346.3860
2. FDA MEDICAL DEVICE DATA SYSTEMS (MDDS) NEW BILL EASES
TELEMEDICINE REQUIREMENTS FOR REGULATIONS TO BE U PDATED VETERANS
HEALTHCARE FCC CALLS FOR COMMENT ON GRANDFATHERED TECH &
INNOVATION: RURAL TELEMEDICINE PROVIDERS ACO PATIENT-CONSUME21
MACRO TRENDS Despite ayoure on the bus, youre off the bus economy,
we are remaining a happy bunch of Americans (81%) in the face of
renewed slippage in our personal and business confidence. What is
also interesting is that the older we are the happier we seem to be
getting. With 58% of us being outside the traditional 25-54 years
of age demographic and the largest group (9%) being the 70+ and
then considering the shift to 52% of those using social networks
being 36+ years (a 58% increase since 2008), we can expect some
wise rethinking about how to reach those who buy, use and provide
the most healthcare.Q1 GDP ADJUSTED UPSLIGHTLYThe U.S. Department
of Commerce delivered a bit ofgood news June 24th, announcing that
real GDP growthduring the first quarter of 2011 was higher at
1.9%(final reading) than its prior estimate of 1.8% provided amonth
ago and Wall Streets estimate of 1.8%, but down fromthe 3.1% of Q4,
2010. The small upward revision was due to anincrease in net
exports, the changes in private inventories,decreases in state and
local government spending andnonresidential fixed investment
countered these increases.(US Bureau of Economic Analysis, June,
2011) TopCONSUMER AND BUSINESS CONFIDENCE SLIPSBased on data
through June 16th, 2011, the ConferenceBoards Consumer Confidence
58.5 reading is lower thanthe consensus estimate of 60.8 and a
decline from theMay reading of 61.7 - the lowest reading since
December2010. This reflects a less favorable assessment of
currentconditions and continued negativism about the
short-termoutlook with fewer consumers than last month
seeingconditions improving over the next six months.The University
of Michigan Consumer Sentiment Indexfor June, 2011 came in at 71.5,
down from the 74.3 inthe previous month. Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 2
3. And finally, the NFIB Business Optimism Index of
smallbusiness sentiment falls in line with the previousconsumer
confidence indices.Doug Short sees these consumer and small
businesssentiments as remaining close to levels associated with
otherrecent recessions. The good news is that the trend sincethe
Financial Crisis lows has been one of generalimprovement and it is
too early to call whether thelatest monthly data will subsequently
be seen as areversal.Given the combination of uneasiness about the
economicoutlook and future earnings, consumers are likely
tocontinue weighing their spending decisions quite
carefully.(Advisors Perspectives, June 28, 2011) TopBY FAR,
MAJORITY OF AMERICANS ARE STILL HAPPY81% of Americans are happy. Of
those, 33% of 2,184 Americans are very happy thisyear - slightly
down from the 35% who were very happy in both 2008 and 2009 -
according to a May, 2011 poll by Harris Interactive. The Harris
Happiness Index is calculated byasking how Americans agree or
disagree with a list of statements like: "My relationships with
friendsbring me happiness", "I rarely worry about my health" and
"At this time, Im generally happy with mylife" or "I frequently
worry about my financial situation" and "I rarely engage in hobbies
and pastimes Ienjoy."The poll also showed: Mens happiness has been
trending down since 2009 - 31% are very happy in 2011, down from
32% last year and 34% in 2009, Women are generally happier than men
and slightly trending up (36% vs. 35%) over 2010, African Americans
are the happiest and trending up from 40% who were very happy last
year to 44% this year, Hispanics are now less happy than they were
last year (35% vs. 39%) yet they remain happier overall than White
Americans who are steady at 32%, No surprise - the highest income
bracket, earning $100K or more per year, are the happiest group
(37%) - most interesting are the least happy who are those who earn
just slightly less, between $75K and $99.9K per year (29% very
happy), Older Americans remain happier than those younger, as has
been the case in all previous years - 50-64 years (37%) and 65
years (42%) and older are very happy and Those who graduated from
college are happier (35%) than those with less (32%) who have never
attended.(Harris Interactive, June 22, 2011) TopMARKETERS CAN MISS
THE LARGEST PERCENTAGE OF BUYERSAccording to US Census and Neilsen
data, 58% (180 Million) of the US population is outsidethe
traditional 25-54 age demographic - of this the largest grouping by
age is the 70+ at9%. Also, consumers age 55 and older have nearly
identical purchasing habits to those age 25-54 inmany consumer
package goods product categories. Top Information Advantage Group,
San Francisco, IAG.co, 415.346.3860 3
4. A SHIFT TO THE RIGHT THE MAJORITY (52%) OF SOCIAL NETWORK
USERSARE 36+, YOUNGER SHOWS STEEP DECLINEThe average age of social
network users rose between 2008 and 2010, according to Pew
Research.Key trends include: The percentage of social network users
age 18-22 fell 43%, from 28% to 16%, The percentage of social
network users age 23-35 dropped 20%, from 40% to 32%, The
percentage of users age 36-49 rose 18%, from 22% to 26% and Most
significantly, the percentage of users age 50-65 more than doubled,
from 9% to 20%.In total, 52% of social network users in 2010 were
36 years old and up, a 58% increasefrom 33% in 2008.(Pew Research,
June 16, 2011) Top HEALTHCARE MACROS The $2.7 trillion healthcare
market has always been an attractive market for the simple reason
that its dependent on someone else providing and paying for it a
natural fertilizer for runaway costs. We also know that persistent
high costs and pending thinner margins (4% down to possibly -1%)
are forcing those who pay for and provide most of our care to be a
bit more collaborative. Its early, but the exciting parts of the
current proposition are the incentives to get the patient on a path
of self-care and monitoring that requires them to think more about
how and what they will pay and whos going to provide it personal
responsibility seems to be a key ingredient in this brand of
reformulation. Information Advantage Group, San Francisco, IAG.co,
415.346.3860 4
5. IDC STUDY: HEALTHCARE IS THE MOST ATTRACTIVE US MARKETIDC
States the FACTS: on a purely economic basis, the U.S. market for
health care isthe most attractive single market in the U.S.
because: $2.7 trillion spent in the U.S. is on health care, which
is now 17 percent of GDP and rising, The total health-care IT
provider spends on a global basis is $25.6 billion: a mix of
hardware, software and services - 40% of that is in the U.S. and
expected to be 53 percent by 2014, Estimates say $700 billion in
wasted time, energy and resources is poured into health care, The
15 US hospital systems account for 29% of the total hospitals in
the country, and 27% of the total beds, Because many providers have
been able to recover about 30% of their overall IT budgets by
optimizing their data centers and infrastructure, they are
investing this in the CPOE, EHR and analytics systems under reform,
43% of providers are accelerating their investment in EMR to
qualify in time for stimulus incentives, and An additional 32
million Americans will in theory have health insurance by 2019, and
insurance companies are required to pay out up to 85% of the
revenue they take in premiums to actual patient care.(CRN, June 16,
2011) TopHOSPITAL SERVICES COST CONTINUES TO RISE YEAR OVER YEARThe
U.S. Bureau of Labor Statistics reports: Consumer prices for
hospital services increased 0.8% in May up slightly from Aprils
0.7% climb the prior month - a year ago, the agencys index of
consumer hospital prices increased 0.5%. The hospital index climbed
6.3% during the 12-month period ended in May compared with an 8.1%
increase a year ago.(Modern Healthcare, June, 2011) Top$8,100 PER
MAN, WOMAN AND CHILD IN 2009In an excellent summary, the July, 2011
National Institute for Health Care ManagementFoundations data brief
Understanding U.S. Health Care Spending concludes that
annualAmerican health care spending hit $8,100 per man, woman and
child in 2009, for a totalof 2.5 trillion dollars. Key points
include: 5% of the US population is responsible for almost 50% of
all spending; conversely, 50% of the population accounts for only
3% of spending. Despite the growing numbers of those being treated
for chronic conditions, spending distribution remains highly
concentrated. 50% of national and 80% of private insurance premiums
were attributed to increase spending for hospital care and
physician and clinical services during the 2005-09 period. Rising
prices per unit of service eclipsed rising utilization rates as the
largest cause for recent expenditure growth. Leading drivers of
rising unit prices and higher utilization rates include advances in
medical technology, higher rates of chronic diseases and increased
provider consolidation and market power. Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 5
6. (NIHCM, July 2011) TopMOST HOSPITALS PREPARING FOR THINNER
MARGINSResearch by a global consulting company posits that the
resulting shift in the payer mix (i.e., moregovernment, less
commercial interests) will likely cause the majority of hospitals
to seetheir average 4% margin sink to -1% or lower over the next
decade unless they beginpursuing major strategic changes now. This
is because historically, the fiscal health of U.S.hospitals and
health systems has been precariously supported by using profits
from commercialhealth insurance plans to cover losses generated
when caring for the uninsured, or lower reimbursedMedi/Medi
patients (Medicare currently provides approximately 30% of all
reimbursements tohospitals -- nearly five times the percentage of
the American population that it insures). Trendscausing this change
include: Companies discontinuing their employer-sponsored coverage
plans, Companies not subsidizing employees healthcare benefits on
health insurance exchanges, It may be cheaper to pay government
penalties than to provide employee coverage at all, The decrease of
employer-sponsored coverage will swell the ranks of
lower-reimbursement Medicaid membership by 16-18 million
individuals during the next decade, and The wave of "baby boomers"
will continue to increase Medicare membership at roughly 3.1% per
year.The dramatic shift to a much larger percentage of government
reimbursements willsubstantially reduce profitability for most
hospitals and health systems (despite thereduction in bad debt
associated with fewer uninsured).(Marketwire, June 20, 2011)
TopAHIP COUNTERS AMA CHARGESAmericas Health Insurance Plans (AHIP)
released research on June 8 supporting theobservation that hospital
systems are growing more dominant in their markets and thuscausing
cost increases. The idea is that doctors and hospitals are behind
cost increases has beena consistent theme of AHIPs public position
on reform and health care public policy for years. According to
AHIP, 80% of 335 markets studied would be considered highly
concentrated by the Dept. of Justice and the Federal Trade
Commissions Herfindahl-Hirschman Index - agencies use the index as
a guide during merger review. AHIP-commissioned research in 2009
showed that hospital consolidation between 1997 and 2006 drove up
the countrys health care spending by one-half of a percentage point
- $10-12 billion annually. Hospital consolidation is not a new
problem. From the late 1990s to 2003, these consolidations affected
90% of people in densely populated locations where the hospital
market qualified as highly concentrated.AHIPs statements counters
other, including the American Medical Association, reportsand
statements arguing that increasing health plan market consolidation
is the reason whypremium rates have been going up even as
physicians have had to accept lower rates.Consistent research
undertakings by the American Medical Association have indicated
thatthe market for health insurance is highly concentrated in
virtually every metropolitan areaof the country. AMA has reported
that one insurer controlled 30% or more of nearly every market,
based on enrollment data from Jan. 1, 2008. Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 6
7. (Amednews, June 8, 2011) TopMCKINSEY QUARTERLY: EMPLOYERS
WILL PUSH TO DROP TRADITIONALCOVERAGEAlthough the Congressional
Budget Office estimated that, under reform measure, onlyabout 7% of
employees will have to switch to subsidized-exchange policies in
2014 fromtheir currently employer-sponsored insurance (ESI)
programs, in a February 2011 survey1,329 U.S. private sector
employers undertaken to measure their attitudes about healthcare
reform,as well as other proprietary research, found: 30% of
employers will definitely or probably be offering ESI after 2014 -
this rises to more than 50% and will push 60% to pursue some
alternative to traditional ESI among those considered to have high
awareness of reform. 30% of employers would gain economically from
dropping coverage even if they completely compensated employees for
the change through offering other benefits or higher salaries. If
ESI was stopped, 85% of employees would remain at their jobs, but
about 60 percent would expect increased compensation.(McKinsey
Quarterly, June 2011) TopEXPECT EMPLOYER-BASED RETIREMENT PLANS TO
BE RETOOLEDAccording to the sixth annual Employer Survey on Retiree
Medical Strategy by Towers Watson: Nearly 60 percent of the retiree
medical plan sponsors cite the high cost of providing coverage and
opportunities under healthcare reform as the main reasons for
retooling retirement plans.Among these sponsors: 87% are examining
the new federally-subsidized insurance options under reform for
pre-age 65 coverage, 73% cite the Cadillac Tax for high-end plans
as a concern.So far, approximately 5% of employers have stopped
group plan sponsorship entirely andswitched to helping Medicare
retirees purchase higher-value medical and pharmacy insurance in
theindividual market through the use of Medicare
coordinators.(International Society of Certified Employee Benefit
Specialists, 2011) TopHEALTH SAVINGS ACCOUNTS GROW 14% The American
Health Insurance Plans(AHIP) association announced that more than
11.4million Americans are now using Health SavingsAccounts (HSA) -
a 14% increase since lastyear. HSAs are tax-exempt trust accounts
that arean alternative to traditional health insurance plansand
offer employees lower insurance premiums ifthey agree to place
money into a special accountfrom which they pay for most of their
lower-cost,basic healthcare. These plans includea catastrophic,
high deductible insurance plan forlarger medical bills due to
hospitalizations, surgeries,or other higher cost specialized
treatments. Information Advantage Group, San Francisco, IAG.co,
415.346.3860 7
8. Based on their annual census, AHIPS January 2010 to January
2011 finds enrollment breaking outas: 2.4 million lives for the
individual market, 2.8 million lives for small-group market and
over 6.3 million lives were covered in the large-group market. 26%
growth for large-group coverage, making it the fastest growing,
with the individual market coverage coming in second at 15% The
leading states include: California (1,073,319 enrollees), Texas
(844,832 enrollees), Ohio (728,868 enrollees), Illinois (690,509
enrollees), Florida (656,243 enrollees) and Minnesota (507,307
enrollees).(AHIP, June 14, 2011) TopEMPLOYERS WILL INVEST MORE IN
WELLNESS/FITNESS PROGRAMSA provision in the ACA law earmarks $200
million for grants to help small businesses setup wellness programs
between 2011 and 2015. Some recent findings include: 86% of
employers plan to significantly increase wellness and health
promotion programs over the next three years and 56 % improving
employee health and 49% lowering healthcare costs topped the lists
of Hewitts 2011 Health Care Survey of 1,028 employers.(Boston.com,
May 31, 2011) TopTHE NEXT GENERATION OF MOBILE APPS TO OFFER VIDEO
HOUSE CALLSIncreasingly over the last year, insurers have begun
offering mobile apps, largely foradministrative functions, aimed at
patients. Payers like United Healthcare and HealthNetalready
provide mobile access to coverage and benefits information,
physician directories, healthsavings account balance totals and
even out-of-pocket drug cost data. More inventive companieshave
expanded to mobile apps for fitness and wellness tracking,
localized allergy alertsand game-based social media apps for
fitness challenges.What is on the horizon includes health apps that
engage the patient with games that areinstructional, challenging
and also have the addictive component of video games.
MicrosoftsKinect is one of these systems that are just now being
explored for exercise and fitness.For the physician, we can expect
the current shift of mobile apps from consumerto biomedical
measurement to continue. We can also expect payers to be looking to
build"collaboration" apps that allow network physicians to
communicate via Smartphone with patients,send secure messages to
other providers, and receive alerts, results and "video house
calls."( FierceMobileHealthcare, June 17, 2011) TopWORLDWIDE MOBILE
HEALTH PROJECTS EARLY DAYS, RELATIVELY LOWTECHA recent World Health
Organization study on mobile healthcare (mHealth) states: Nearly 50
percent of the mHealth projects underway around the world involve
telemedicine, Although worldwide mHealth is growing exponentially,
theres no organization to it, The biggest problem with this growth
is that, while 83% of the 112 countries studied have mHealth
projects ongoing, most are pilot projects with only 12% of these
evaluating the success of their mHealth programs, Information
Advantage Group, San Francisco, IAG.co, 415.346.3860 8
9. Europe (and the U.K., specifically), are the leading
mobile-enabled countries when it comes to healthcare; Africa has
the least mHealth involvement, and Appointment reminder (71%) is
the most common use for mobile devices in high-income countries; in
low income countries the two mHealth applications are lower-tech
health call centers (59%) and emergency phone services
(54%).(FierceMobileHealth, June 10, 2011) TopMINNESOTA PIONEERS
ALLIED HEALTH WORKFORCE EXPANSIONMinnesotas lack of rural
physicians has opened the door for mid-level practitioners totake
on a greater role in providing health care. Called community
paramedics, this newcategory of healthcare personnel targets
underserved rural areas. Most of us accept nursepractitioners and
specially-trained nurses to perform physical exams and prescribe
medications.Whats new is the idea of using mid-level practitioners
to fill health care gaps. An example isMinnesota being the first
state in the nation to license "dental therapists," who perform
duties that fallbetween those of a dental assistant or hygienist
and those of a full-fledged dentist - they can fillcavities and
other simple procedures, under the supervision of a licensed
dentist. Or, it is also thefirst state to pass a law establishing
certification for community paramedics who might suture awound,
adjust a medication, or address an asthma attack or allergic
reaction.(MPRNews, June 20, 2011) Top ACO Objections on the
proposed rules for ACOs (as they are written) are often seeded with
the less than glowing results from federal ACO pilots where only
40% of physicians got a shared savings bonus. The truth is, - the
pilot did slow Medicare spending across the board. Other refined
ACO-like pilots have been turning in good results. This has most
looking for the best way to structure and align with the developing
ACO model.EARLY FEDERAL ACO PILOTS FALL SHORT ONRETURN AND COSTSA
key government five-year test of the ACO conceptenlisted 10 leading
health systems around the country andoffered financial bonuses if
they could save enough bytreating older patients more efficiently
while providinghigh-quality care: By the last year of the study,
2010, only 40% of the long-established groups run by doctors,
slowed their Medicare spending enough to qualify for a bonus. Two
sites saved enough to get bonuses in all five years; three did not
succeed even once.Other work has shown that the financial
investments for infrastructure and re-engineering have been higher
than the government has predicted, causing it to lose moneyfor at
least the first few years. The ACO rules will be final in December
and much moreresearch is needed on these cost and return
issues.(NCPA, June 8, 2011) Top Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 9
10. CALIFORNIA HYBRID ACO PARTNERSHIP SHOWS $15.5 MILLION IN
SAVINGSFour years ago, Blue Shield of California, Catholic
Healthcare West and Hill PhysiciansMedical Group partnered to form
their version of an ACO in response to concerns aboutrising health
care costs and their effect on policyholders. Now in 2011, the
partnership said forCalPERS 41,500 members have seen: Health care
spending was reduced by $15.5 million in 2010, Premiums did not
rise between 2009 and 2010 and There was a 15% reduction in the
average length of hospital stays and readmissions.The partnership
stated that much of the savings were created by eliminating
duplicative positionsand jointly funding new positions to make care
more efficient. They also indicated that it didntrequire a
significant amount of capital to start their
partnership.Headquartered in San Francisco Catholic Healthcare West
(CHW) is the fifth largest hospitalprovider in the nation and the
largest hospital system in California. It has stated that it does
notintend to participate in the federal governments ACO efforts
because as the rules arewritten, the bar is currently set too high
for the incentives offered.(California Healthline, June 27, 2011)
TopKPMG SURVEY: MOST PROVIDERS ARE STILL THINKING ABOUT AN ACO,MOST
PAYERS DONT HAVE A STANCEIn April, KPMG polled leaders of
healthcare systems, hospitals and healthcare payers about
theirparticipation in the Centers for Medicare and Medicaid
Services shared savings program (MSSP) the Medicare ACO program and
found that most are still thinking about it. 64% of hospital and
health system executives either didnt know their organizations
position (39%) or were in a wait-and-see mode (25%) about
participating in the MSSP - either position wouldnt allow them to
be ready for the launch of the program, planned for January 1,
2012. 61% of payers said they didnt know what their organizations
stance (50%) was or were in a wait-and-see mode (21%) on the
MSSP.(Healthcare Financial News, June 30, 2011) TopHFMA: 12
ESSENTIALS FOR ACO SUCCESS REPORTHFMA 2011 Leadership report
describes Baylor Health Care System 12 ACO essentials forsuccess
that focus on people, quality, and finance and include: 1.
Effective and Shared Governance 2. Aligned and Efficient Clinical
Workforce 3. Informed and Skilled Participants/Workforce 4.
Interoperable, Data-Enabled Environment 5. Quality 6. Attribution,
Assignment, and Capacity Management 7. Anchored Patient-Centered
Medical Home 8. Care Coordination and Patient Compliance 9. Risk
Assessment and Acceptance 10. Cost Monitoring and Reduction 11.
Provider Reward Methods/Incentive Design Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 10
11. 12. Sustainable Business Structure(HFMA, 2011) TopPHYSICIAN
ALIGNMENT IS THE MOST CRITICAL STEP FOR DEVELOPING ANACOA recent
survey of 882 administrators and physicians highlighted that, while
capital,infrastructure and data analytics are key structural
components regarding both ACOformation and the industry-wide effort
to enhance quality of care and reduce costs,physician alignment was
most pivotal: 58% stated they are either in the process of forming
ACOs or are thinking about it - of these, 42% said physician
alignment is the most serious obstacle to their efforts, followed
by lack of capital (38%), lack of integrated IT systems (31%), and
lack of evidence-based treatment protocol data (25%). 42% will not
form ACOs in the near future - of these, 40% cited physician
alignment as a reason they are not, followed by lack of capital
(31%), lack of integrated IT systems (26%), and lack of
evidence-based treatment protocol data (23%).(MarketWatch, June 20,
2011) TopTOP FIVE: ALIGNING PHYSICIANS FOR THE ACOPeggy Naas, MD,
MBA, vice president of physician strategies at VHA, Dallas, TX has
one of thebetter lists for developing strategies for successfully
aligning physicians with a hospitalduring the creation of an ACO:1.
Focus on clinical outcomes being delivered efficiently and in a way
that benefits the entireorganization.2. Choose a specific model
suited to the culture of the enterprise: Employment -Hospitals can
employ or contract physicians as a step on the way to align them
with the organization. Co-management - Physicians are employed or
otherwise paid for administrative roles or clinical leadership
tasks and other administrative leaders would have or preferably
share outcome-based incentives. Clinical integration - Health
systems and hospitals partner with health system-employed and
self-employed physicians on specific performance metrics.3. Foster
physician leaders who can participate in committees; listen to them
and start nurturing theirunderstanding of the broader organizations
work and the perspective of the board," she says.4. Be visible in
the enterprise and transparent about the health systems or
hospitals performanceand outcomes, no matter what the outcome -
positive or negative.5. Create a culture conducive to alignment and
experiences involving collaboration.(Becker Hospital Review, June
27, 2011) TopDOJ SAYS MOST ACOS WONT HAVE ANTITRUST PROBLEMSAt the
Second National Accountable Care Organization Summit in Washington
June 27th, deputychief of the legal policy section/antitrust
division of the Department of Justice GailKursh, JD, stated:
Information Advantage Group, San Francisco, IAG.co, 415.346.3860
11
12. An ACO will be considered legitimate if it is a clinically
integrated collaboration of otherwise independent providers and not
a vehicle for competitors simply to raise prices and Most ACOs
would not have problems with their legality under antitrust
provisions on the proposed rules.Under current proposed rules, to
participate in the Medicare Shared Savings Program, would-beACO
collaborations that have more than a 50% market share of a primary
service area (PSA) wouldneed to demonstrate that their percentage
of the market does not create market power oranticompetitive
behavior. However, what constitutes a clinically integrated
collaboration remains tobe figured out.(FierceHealth, June 27th,
2011) TopNEWLY RELEASED - CMS ACO HELPFUL RESOURCESCMS Proposed
Rule establishing ACO Program DetailsRequest for Information
Regarding Accountable Care Organizations and the Medicare
SharedSavings ProgramIRS Request for Comments Regarding the Need
for Guidance on Participation by Tax-ExemptOrganizations in the
Shared Savings Program through ACOsImplications Regarding
Antitrust, Physician Self-Referral, Anti-Kickback, and Civil
Monetary PenaltyLawsProposed Statement of Antitrust Enforcement
Policy Regarding Accountable Care OrganizationsParticipating in the
Medicare Shared Savings Program MEDICAL HOME Objections about the
proposed rules for ACOs (as they are written) are often seeded with
the less than glowing results from federal ACO pilots where only
40% of physicians got a shared savings bonus. The truth is, - the
pilot did slow Medicare spending across the board. Other refined
ACO-like pilots have been turning in good results. This has most
looking for the best way to structure and align with the developing
ACO model.FIRST ONCOLOGY MEDICAL HOME REDUCES
HOSPITALIZATIONSConsultants in Medical Oncology and Hematology, PC
(CMOH), a private practice in southeasternPennsylvania, has become
the first oncology practice in the nation to achieve level III
recognitionfrom the National Committee for Quality Assurance as an
oncology patient-centered medical home(OPCHM) with results that
include: CMOH chemotherapy patients ER visits are half the rate
reported in another large commercially insured population and 65%
lower than their practices own 2006 rate in 2006. CMOHs rate of
hospitalizations per chemotherapy patient per year has dropped by
43% since 2007.(Fierce Health, June 14, 2011) Top Information
Advantage Group, San Francisco, IAG.co, 415.346.3860 12
13. ONLY 35% OF UNDER 20 PHYSICIAN PRACTICES USE MEDICAL
HOMEPROCEDURESA just released study in Health Affairs offer the
firstnational data on to what degree 1,344 medicalpractices with
fewer than 20 doctors had adopted theseven fundamental principles
of medical homeprocesses showed: Across all entities, only 35% used
medical home processes, and overall earned only 21% of the medical
home points, Adoption was greatest for the largest medical groups
(>140 physicians) and those owned by large entities like
hospitals and Contrary to the studies assumption, practices serving
a high percentage of minority or poor patients were not less likely
to be using medical home practices.With 35% of visits to US
office-based physicians are to solo practitioners, and 88% are to
practiceswith nine or fewer physicians, the study offers several
strategies to raise these scores.(Health Affairs, June 28, 2011)
TopCOORDINATION OF CARE IMPROVES WITH EHRA 12 month study of 119
patients, about half at Taconic Independent Practice Association in
NewYork State and the rest at eHealth Initiative, Sanofi-Aventis
and Health & Technology Vector, aHartford, Conn.-based health
IT and care redesign firm, the study found many processimprovements
in the care with the inclusion of an EHR in the workflow that
included: More information being transmitted to patients during
each clinic visit, more frequent setting of goals, and more
complete summaries being transmitted from primary care physicians
to cardiologists, Electronic communication between cardiologists
practices was problematic due to processes not being in place, the
communities did not have the tools for electronic data exchange,
and the providers did not have compatible EHR systems. However,
researchers also reported that some cardiologists were interested
in expanded exchange of electronic clinical data.Researchers
concluded that to be sustainable and successful, care coordination
requires ongoingand explicit three-way communication between
patient, primary care physician, and specialist.(Information Week,
June 23, 2011) TopNEWLY RELEASED - HELPFUL RESOURCES:American
Academy of Pediatrics: From pediatric to adult medical homes Joint
report outlines howto plan, execute better health care transitions
for all patientsThe Joint Commission has developed Primary Care
Medical Home which enables the potential forincreased reimbursement
when the additional requirements of a Primary Care Information
Advantage Group, San Francisco, IAG.co, 415.346.3860 13
14. HIE Were beginning to see more growth in privately offered
HIEs verses public to help physicians qualify under meaningful use
rules. Part of this shift is driven by a physicians affinity to
local affiliations, like hospitals and IPAs, and trade associations
way before governmentalhealthcare happens locally not regionally or
nationally.THE AMERICAN ASSOCIATION FOR FAMILY PRACTICE LAUNCHES
LOW-COSTMESSAGING SERVICE (HIE)The American Association for Family
Practice Physicians Direct is now available to itsmembers for $90 a
year. The service is intended to assist members meet meaningful
userequirements and is a secure clinical messaging system allowing
the sending of unlimited number ofmessages and data files to their
clinical colleagues and other trading partners. The system is
acollaboration with Surescripts, one of the largest electronic
prescription networks in the US.(AAFP, June 22, 2011) TopMAINE
PASSES OP-OUT HIE REQUIREMENTMaine has passed legislation requiring
healthcare providers participating in the states HIE to
provideinformative pieces that describes risks and benefits and how
to opt-out. This action is the resultsof a public hearing that
illuminated that a proposed op-in model had not garnered
supportfrom major stakeholders. The proposed legislation also
requires the HIE to offer online and offlineaccess to who, when and
where has accessed their records by patients. TopLESSONS LEARNED
FROM CONNECTING TO THE NATIONWIDE HEALTHINFORMATION NETWORK
(NWHIN)Lessons shared about connecting to the NwHIN were offered by
the North Carolina HealthcareInformation & Communications
Alliance Organizations during a recent webinar: Be prepared for an
abundance of interoperability testing and review before any
information can be exchanged, Be ready for the intensity of
developing and proving conformance and interoperability through
partner testing that all has to take, Governance must be in place
and must have the technical requirements installed first and then
the networks governing body must approve the entities for
interoperability and partner testing, and The cost of this is more
on the enterprise and community HIE side than it is on the gateway
connection to the NwHIN.Currently, those connecting to the NwHIN
must be federal agencies or have a contract with a federalagency
that covers these types of activities.(CMIO, June 20, 2011)
TopNEWLY RELEASED - HIE HELPFUL RESOURCES:HIMSS Electronic Health
Record Association, a vendor trade group, has developed a white
paperthat lays out a framework for health information exchange by
connecting EHRs more rapidly. Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 14
15. The eHealth Initiative has the second phase of its updated
HIE Toolkit that addresses creating asustainable model, technical
consideration of connectivity, marketing your HIE, auditing and
value-add services and working examples of documents and other
helpful materials. Top PHYSICIAN & PROFESSIONALS The attention
directed toward the physician-to-consumer market under all of the
new rules and models for healthcare have providers thinking hard
about how to gain efficiencies and improver the consumer
experience. Improved communication and patient participation and
collaboration through the use of technology are proving itself
again.PATIENT EXPERIENCE A LONG LIST OF ROOM FOR IMPROVEMENT IN
THETYPICAL OFFICE VISITIntuits April 2011 Health Patient Engagement
Study survey of 556 U.S. physician practices about thepatients
experience in their office found: Almost 25% of providers who are
not online think it is hard for patients to reach them to ask
questions, make appointments or receive lab results, Almost 50% of
physicians said their practices are typically running 30-60 minutes
behind schedule, 33% of a providers office staff spend three or
more hours per day trying to get follow-up information to patients,
83% of doctors say it takes more than one reminder before a patient
pays their bill, 45% say phone interruptions happen so frequently
they impact office efficiency. 72% say patients complain about
having to repeatedly fill out the same paper forms, and 50% say
their patients complain about spending too much time in the waiting
room.To improve on these inefficiencies: 95% of doctors want their
patients to fill out necessary forms online before their
appointment, 81% of patient agreed, 67% percent of providers are
planning to build add a patient portal, communication or EHR
solutions in the next 12 months under ARRA to provide patients with
access to health records and clinical information, appointment
scheduling and prescription refills.(HealthcareITNews, June 14,
2011) TopBETTER PHYSICIAN-TO-PATIENT COMMUNICATIONS IS THE KEY
TOIMPROVING PERCEIVED QUALITYCommunication between patients and
clinicians still follows in one-way direction from
doctor-to-patient. However, The New EnglandHealthcare Institutes
(NEHI) recent teleconference took a hard look at thiscommunication
channel and produced some valuable information andconclusions: The
ACA of 2010 includes a number of provisions that encourage the
development and use of shared decision-making and improved
patient-clinician communication. Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 15
16. The law also calls for the measurement of communications
quality and the information provided to and used by patients,
caregivers, and authorized representatives to inform
decision-making. Providers will increasingly be held accountable
for their communication with patients, as exampled by the current
use of patient satisfaction surveys (the Hospital Consumer
Assessment of Healthcare Providers and Systems survey), which are
currently part of Medicares Hospital Inpatient Quality Reporting
program and included under the measures for the first year of the
Value-Based Purchasing Program set to begin in October 2012 (FY
2013). As a guide for better patient-to-physician communications,
two work groups (the Evidence Communication Innovation
Collaborative and the Best Practices Innovation Collaborative)
under the Institute of Medicine Roundtable on Value and
Science-Driven Healthcare have developed a set of core principles
and expectations to communication. Early demonstration results show
that because patients are getting exactly what they want, providers
save time because patients come to appointments more prepared and
have greater risk perception.(NEHI, June, 2011) TopCANADIAN
PHYSICIANS RECEPTIVE TO PHRWITH THE USUAL CONCERNSA new study of
Canadian physician attitudes toward personal health records (PHRs)
discovered: Physicians generally saw PHR adoption as an inevitable
and positive step forward, Portability and potential to engage
patients especially appealed to the docs.Common concerns included:
Concerns about how PHRs could affect data management,
patient-physician relationships and practice management issues,
Security and privacy were top concerns, Unnecessary anxiety as
patients struggle to make sense of the complex information, if
information is shared without the conventional framing by a
physician,One conclusion by a physician about a patients use of
PHRs, If youre going to make (PHRs)worthwhile, you need to ensure
patients are able to interpret the information they are receiving,
ableto interpret it properly, and able to do something useful with
it; otherwise, you are going to createchaos.(iHealthBeat, June 14,
2011) TopVA PHYSICIANS STILL USE WORK-A-ROUNDS WITH EHRA new study
by the Veterans Administration showed that, even among practices
with advancedelectronic health record (EHR) systems, physician
workarounds persisted. Results included: Physicians used 11 types
of workarounds that included: printing out copies of instead of
viewing them on the screen, writing notes to help them remember
things, and building computer spreadsheets to keep track of
referrals. Communication breakdowns and some computerized consult
management redundancies were also discovered.(International Journal
of Medical Informatics, July, 2011) Top19% OF PHYSICIAN USING
TABLETS CLINICALLYAccording to a survey of 3,800 physicians, use of
mobile devices is growing rapidly: Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 16
17. 83% of respondents own at least one mobile device, 25%
think of themselves as Super Mobile" who use a smart phone and
tablet device, 30% of respondent are using a tablet, 19%
clinically, The most common professional uses of mobile devices
are: look up drug and treatment reference material, learn about new
treatments and research, and search for information on diagnoses,
treatment paths, and educating patients. No age barrier to tablet
adoption, and a slight to moderate age barrier for smart phone
adoption, The iPhone (60%) was the most popular smart phone, and
the iPad was essentially alone in the tablet space, and Android
tablets were used by only a few.(QuantiaMD, June 15, 2011)
TopPATIENT LIKE IPAD EDUCATION VIDEOSPatients using education
videos on iPads atmoments of natural downtime during their
physicianvisits for 3 to 5 minutes and covering their diseasetopics
are being received well. Although its early,results show that the
modules have improvedpatient knowledge and generated positive
feedback without placing additional demands onphysicians or staff.
The videos were developed by Wake Forest Baptist Health and Wake
ForestUniversity School of Medicine.(AHRQ, June 2011) Top
PATIENT-CONSUMER -CAREGIVER The Consumer Miracle in healthcare
requires the patient-consumer to invest more of themselves and
their money in seeking a healthy life - another round of studies
are showing the patients willingness to do so and the consequences
on not.PWC: CONSUMERS WILL SPEND $13.8 BILLION OF THEIR OWN MONEYA
new report by PwC concludes that consumers would be willing to
spend approximately$13.6 billion a year of their own money on
healthcare services: Included in the $13.8 Billion is $4 billion on
health-related video games, $8.9 billion on consumer rating of
physicians and hospitals, and $700 million on mobile health
applications. Younger consumers (18 to 24) are twice as interested
in mobile health applications or programs and three times more
interested in health-related video games than those 65+. Demand for
convenience and transparency in services and pricing is spurring
alternative sources of healthcare services like retail health
clinics which grew from 10% to 17% over the 2007-10 period.(PwC,
June 2011) Top Information Advantage Group, San Francisco, IAG.co,
415.346.3860 17
18. CONSUMERS WILLING TO PAY FOR NEW GENERATION OF HEALTH
DEVICESA survey of 1300 consumers currently using wellness and
health devices and conducted by the IBMInstitute for Business Value
showed that consumers are demanding a new generation of
healthdevices, greater simplicity and better information sharing.
Leading reasons driving the buyare: 96% - ease of use is the key
factor in selecting one device over another, 75% - consider price
well ahead of features, customer support, warranty or stylish
design and 86% - want real-time, easy-to-understand feedback from
their devices.Moreover, the study finds, theyre willing to pay for
devices especially with $100 or belowprice point; and over 33% of
current device users expect to pay for part of the cost ofnew
health devices over the next two years and 35% also expect monthly
service fees.The report goes on to present a vision of key areas of
growth that include dieting, eldercare, bloodmonitoring, mobility
and communication. Here too the theme of collaboration rings for
vendors andcontent providers to work together to amplify the
utility of each device.(HealthcareITNews June 23, 2011) TopMEDICAID
PRICE CONTROLS LIMITS CHILDREN GETTING CAREA University Of
Pennsylvania, School of Medicine study found that children on
Medicaid wererefused appointments by 66% of specialists and had to
wait 22 days longer for anappointment than kids with private
insurance. The primary cause was seen as Medicaids pricecontrols,
which one survey reports 24 states plan to ratchet down even
further.(NEJM, June 16, 2011; National Governors Association
Survey, spring, 2011) TopYOUNG CANCER PATIENTS SPEND ALMOST FOUR
TIMES AS MUCH AS THOSEWITH OTHER CHRONIC CONDITIONSA recent study
in the Journal of Clinical Oncology found that 13% of non-elderly
cancer patientsin the U.S. spend more than 20% of their income on
healthcare, including health insurancepremiums. This compares to
almost 10% of non-elderly adults with chronic conditions other
thancancer and only 4.4 percent of non-elderly adults without any
chronic condition. TopNEWLY RELEASED -
PATIENT-CONSUMER-CAREGIVERHELPFUL RESOURCESThe National Prevention
Strategy is a comprehensive plan that will helpincrease the number
of Americans who are healthy at every stage of life. TopBOOMERS
NEED EDUCATION ON HOW TO CARE FOR THEIRPARENTSA survey of 600
Boomers aged 45-65 say theyre likely to become caregivers for their
parents, but...: Only 51% can name any medications their parents
take, 31% dont know how many medications their parents are on, 34%
dont know if their parents have a safe-deposit box or where the key
is, and 36% dont know where their parents financial information is
located.(Sun Times June 21, 2011) Top Information Advantage Group,
San Francisco, IAG.co, 415.346.3860 18
19. OVERSIGHT -INFLUENCE -INNOVATION There continues to be any
number of consumer health apps and devices entering the market
weeklywith few showing a sustainable business model. This has
hidden a shift away from pure consumer plays toward tools to
improve communication and care across the provider-consumer
continuum. The VA continues to promote telehealth while the
commercial and federal markets ask for more data the VA must know
something.REGULATORY:FDA MEDICAL DEVICE DATA SYSTEMS (MDDS)
REGULATIONSTO BE UPDATEDTheres a shift from mobile health apps and
devices being primarily consumerproducts to becoming useful tools
to connect patients and caregivers toclinicians. These tools are
expected to fall under FDA 501 (k) rules for medical devices when
theFDA begins regulating mobile health apps. Currently, the FDA
defines medical device data systems(MDDS) as hardware or software
products that transfer, store, convert formats, and display
medicaldevice data it does not control the device or modify the
data or its display.(Information Week, June 7, 2011) TopFCC CALLS
FOR COMMENT ON GRANDFATHERED RURALTELEMEDICINE PROVIDERSThe Federal
Communications Commission has adopted an interim final rule
toenable providers, who were "grandfathered" after the FCC changed
its definitionfor a "rural area" on July 1, 2005, to continue to
participate in rural telemedicineprograms that receive subsidized
telecommunications rates. The FCC iscurrently seeking comment on
whether to make these grandfathered providerspermanently eligible
for discounted telecommunication services.(Health Data Management,
June 27, 2011) TopNEW BILL EASES TELEMEDICINE REQUIREMENTS FOR
VETERANS HEALTHCAREThe Service Members Telemedicine and E-Health
Portability Act, also known as the STEP Act, wasadded to the
recently passed $690 billion Defense authorization bill. . Although
the legislation wasdesigned for mental health services, it will
help expand access to other types of medical care besidestelehealth
services to veterans across the U.S. In addition to making it
easier for providers to usetelehealth tools including video links,
cell phones and Skype, the bill would exempt care providersfrom
having to obtain a medical license in the patients state. Providers
still need to be licensed bythe Department of Defense.(iHealthBeat,
May 31, 2011) TopTECH & INNOVATION:Smartphone and tablet users
still using the desktop or laptop to access the Internet: 56.4% -
Desktop 39.6% - Smartphone 4.0% - Tablet Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 19
20. Rock Health, a seed accelerator for Web and mobile health
applications,has chosen ten start-ups from more than 350 entries as
part of its inauguralprogram. The chosen reflect trends that are
shaping the next generation ofhealth-related applications. The ten
are:1. BrainBot technology to improve mental performance;2.
CellScope at-home disease diagnosis;3. Genomera personal health
collaboration;4. Health In Reach medical procedure marketplace;5.
Omada Health clinical treatment social networking application;6.
Pipette patient monitoring and education;7. Skimble mobile fitness
application;8. WeSprout connecting health data and community; and9.
Three additional start-ups in stealth mode.The start-ups now enter
a 5-month program with funding in the form of a $20,000
grant;infrastructure; strategic medical, branding, communications
and legal support; and mentoring fromexperts.(Healthcare ITNews,
June 2, 2011) TopThe U.S. Department of Health and Human Services
(HHS) andthe Institute of Medicine (IoM) co-hosted their second
annualevent June 9th focusing on innovative applications and
servicesthat harness the power of open data from HHS and
othersources to help improve health and health care. Some
notableapplications included: iTriage - An iPhone app that allows
users to select their symptoms, severity, etc., and then the app
guides the user to a nearby clinic, physicians office, or hospital
based on his or her selections. Ozioma - A community-based app that
aggregates data from HHS, CDC, NIH, and other sources (65 sources
and 300 data sets in total). The app is for use by the press,
writers, and communications groups. Healthline - SPG (surgical
procedure guide) is a Web-based patient education application.
Users can learn about their procedure, view hospital-compare data
and costs and choose their doctor. Asthmapolis - Tracks where and
when people use their asthma inhalers. Shows on a map where and
when people have attacks - the app also improved asthma control
from 25% of the time to 62% of the time. CommunityCommons.org -
Connects individuals who are involved in the community health
movement.(HHS Live, HHS, June 9, 2011) TopThe Aetna Foundation, the
philanthropic arm of healthcareinsurer Aetna, has partnered with
the Health 2.0 Conference inSan Francisco on September 25-27, 2011
to issue a developerchallenge. The idea is to spur new interactive
browser-basedapplications designed to make data about obesity
moreaccessible and usable. The prize for the best application will
be $25,000 and two free passes to theconference. Second prize will
be $15,000, and third prize will be $10,000. Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 20
21. (Healthcare ITNews, June 10, 2011) TopACOHealth information
technology company McKesson Corps healthinformation technology
group announced that it has signed a deal toacquire Portico
Systems. The acquisition will boost McKessonsofferings as a
provider of financial management tools for the ACOmarket which
calls for new products that support value-basedreimbursement
incentives to align payers and providers on controlling cost and
optimizing healthoutcomes. TopPATIENT-CONSUMER A new translation
app for mobile devices helps the hearingimpaired by enabling the
user to speak into a device andhave the translated text appear;
type-to-type translationsalso are available for situations that
require quiet or for thosewho have trouble speaking. The
application can support upto 1,000 voice recognition-based
transcriptions; text-to-text and text-to-speech transcriptions
areunlimited. $99. TopWith trend toward off-the-shelf computers
increasingly beingable to replace proprietary devices, Care
Innovations is a jointventure between GE and Intel with its first
product to be TheGuide, a table vital sign monitor and two-way
telehealthcommunication device. This is the first step in a
transitionaway from purpose-built devices and toward
device-agnosticmedical apps. It will run on any Win7 platform and
they wioll recruit other vendors to offer devicesthat best fit each
patients needs. TopThe No. 1 paid medical app in the U.S. Apple App
store is called Pill Identifier andworks by communicating with a
searchable database of pill images of more than14,000 prescription
and over-the-counter medications found in the U.S. 99 cents forthe
lite version $39.95 for the premium. TopThere has been an avalanche
of mobile applications both for the consumer andprofessional see
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Advantage Group, San Francisco, IAG.co, 415.346.3860 21