As promised, here are a few collections from and reflections on the World Health Care Congress being held here in our nation’s capital.

The organizers of WHCC have done a great job pulling together a wide range of movers and shakers in the healthcare sector. From former Secretary of State George Schultz, who recently authored a book on the US crisis in entitlement programs, Medicare/Medicaid being one of them, to Toby Cosgrove of Cleveland Clinic to the leading healthcare advisors of the candidates for President and everything in between. Some good talks and even better discussions in the halls. This is an excellent networking event.

So what have I learned today? Following are some snippets:

• Adoption by Cleveland Clinic customers of Google Health has increased from 1,370 to 1,600 hundred today. Out of 10,000 invited to participate in this Beta of Gogle Health, looks like their are some issues regarding adoption – not exactly a stampede. Google may face the same chllenges as others – how do we get consumer engagement?
• From George Halvorson, Chairman and CEO of the Kaiser Foundation had the following to say (this is paraphrased, not a direct quote)

Healthcare is the fastest growing industry in the US with very good margins and amazingly very low accountability and poor quality. Part f the problem is that healthcare is awash in golden eggs and very smart people! No way will the healthcare industry correct itself – they will not kill the goose laying those golden eggs. Healthcare industry is currently dependent on cash flow, thus no player will take actions to reduce cash flow – they are not incented to do preventative care.

The missing link are the employers who are paying for care. Employers need to force the change, it will not come from the vested interests.

• Harvard Business School Prof. Clayton Christensen sees retail clinics as a major disruptor to healthcare. Also sees employers who are now beginning to negotiate directly with large healthcare providers for services will also be the ones that further push medical tourism, hich is another major disruptor. Tip: Those in the medical tourism services space should then be doing their competitive intelligence to understand who those employers are and begin positioning themselves to erve large employers and not just individual consumers.
• Sat in on an excellent presentation from a Dr. Reti of New Zealand who spoke about the medical home model in his country. After his presentation I asked him if an EMR was critical to enable the medical home concept. His belief is that you can not do it without one. In New Zealand the government required all physicians to adopt an EMR and the physicians paid for it themselves! Dr. Reti siad yes, there were some struggles with adopting an EMR, and yes there were workflow/productivity issues and yes, there was a negative return on investment (ROI) initially. But three years later, physicians in New Zealand are seeing the benefits. His advice: Bite the bullet, accept the up-front pain, think through what you want to accomplish with your EMR and expect an ROI a few years hence. Its an investment.
• HealthGrades is now experiencing some 5 million unique visitors a month, over double what they saw last year. They are now beginning to sell directly to employers to hosting the HealthGrades system directly within an employer’s internal health and wellness portal, thus directly competing with WebMD. See themselves doing well against WebMD in bake-offs. They have also begun selling services to providers where providers can now put up personal, provider-created profiles. Pretty shaky ground they are on in doing this as they now cross the line serving both as a neutral rating service of providers by consumers as well as allowing providers to pay to create their own profiles. This would be like Zagats having its restaurant rating book littered with little restaurant advertisements and profiles – not a good mix in my view. Really believe HealthGrades would be better off serving one market or the other, but not both. Simply too many potential conflict of interests issues (real or imagined) that they would need to manage.
• Talk to one of the better PHR vendors in the market (they are profiled in our upcoming PHR Market Report) who related to me that they have seen a huge pick-up in business. Prospects who had previously been kicking the tires are now coming back with real needs and willingness to engage and most importantly, their checkbooks are open. One of the more interesting challenges they are running into is the lack of knowledge on what a PHR is and the terms used to describe various PHR functions. For example, one client confused portability with an ability to hand carry the PHR, ala USB device, versus the more common term of portability of records whereby the consumer maintains access and control regardless of provider or insurer. Bottom Line: The PHR market appears to be robust, but most buying is being done on faith rather than hard, demonstrable metrics on the ROI of PHR deployments by employers, providers and health plans.