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#WWBR Week of May 4th, 2015

by John Moore lll | May 08, 2015

Our posts from earlier in the week:
May 5 – John: IBM in Healthcare: Deja Vu or Something New?
May 4 – Brian: HIMSS’15: NOT on FHIR


The Future Of Medicine — Where Investors Are Putting Their Money
Nikhil R. Sahni, Robert Kocher and David M. Cutler in Forbes
“Article is a bit thin, being but a summary of what appears to be some good research, and their characterization of enterprise software is odd. But don’t let that detract you from reading this article that takes a close look at the rapid growth in VC investment in HIT and what it may mean long-term.” – John

Findings from a Survey of Health Care Delivery Innovation Centers
Commonwealth Fund
“Survey results by the Commonwealth Fund that is the ‘first of its kind’ in terms of surveying innovation groups/transformation centers that are associated with health systems. Some interesting results including the wide variation in demographics & funding these groups receive. The thing that really grabbed my attention though was despite care coordination being a high priority area the work around this issue seems centered on working with physician & nurses in the outpatient setting with a moderate focus on the patient’s home & very little focus on post-acute sites of care or other providers including behavioral health. Also seems to be a focus on doing this through the EMR too. From what we have seen, this approach just isn’t going to move the needle on care coordination in a meaningful way.” – Matt

Helping Doctors Choose Wisely: Three Innovative Principles For Health Care Organizations
Jon Tilburt and Susan Dorr Goold in Health Affairs Blog
“The tension between organization-mandated clinical processes and the clinical judgment of the individual is an important consideration for VBP. Eliminating wasteful practice variations will certainly bend the cost curve but individual clinicians believe that patient care can suffer from overly prescriptive, top-down mandates. This blog post advocates three ways to optimize clinician alignment. HCOs should take the long view and nudge, rather than mandate, clinician choices.” – Brian

Vital Signs: Core Metrics for Health and Health Care Progress
Institute of Medicine Report
“An IOM committee recommended that the federal government lead the adoption of 15 core measures, or “vital signs,” and 32 related priority measures to track improvements in health and health care. Some of the measures are very straightforward while others are much nebulous including several that are related to a particular patient around social/community care. A preliminary survey conducted in support of the IOM report found that to meet existing quality measurement requirements, health systems need an average of 50 to 100 employees, including physicians, at a cost of $3.5 million to $12 million annually. With Medicare not planning on consolidating the various physician reporting programs until 2019 at the earliest and more than 40 percent of physicians already refusing to submit measures as a part of PQRS, physicians are going to be spending a lot of time, energy, and dollars to submit various quality measures and make some tough decision on when they won’t decide to comply.” – Matt

They’re Your Vital Signs, Not Your Medical Records
David J. Brailer in The Wall Street Journal
“When you broach the question of who owns distributed medical records, a typical response runs something like, “everyone owns them” or “no one owns them.” Unfortunately, in our legal system, someone owns each and every thing. This op-ed from Dave Brailer advocates that patients should own their data – in every sense of the word. This issue and the questions it raises lurk in every discussion and challenge related to interoperable medical records.” – Brian

How to Solve the E.R. Problem
Ezekiel J. Emanuel in The New York Times
“New data points to an old problem: When you simply expand insurance access, ED visits go up. Ezekiel Emanuel cites several studies, including the most recent one by the American College of Emergency Physicians, pointing towards this troubling trend. Patient Engagement is a key component of successful programs, such as one in Group Health Cooperative in the Seattle area. Beyond educating society about how to use these services, GHC combined cash incentives and responsive benefit design to engage the local population enough to reduce ED use by 27% over the last four years. The bottom line: Health systems need to engage their patients as much as they need to retool their own accessibility through better messaging, pricing, and flexibility.” – Naveen

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