A good starting point for reducing U.S. health care expenses overall is to implement a long-term strategy to reduce the costs associated with unmanaged chronic conditions. The Medical Home: Disruptive Innovation for a New Primary Care Model, a new paper by the Deloitte Center for Health Solutions, part of Deloitte LLP, offers a strategic perspective on this potential solution to address the challenge of chronic care management.
Quote: "There is widespread consensus that any transformative solution requires the inclusion of disruptive innovations that leverage technology. Using in-home monitoring devices in tandem with care management programs to enhance self-care for chronic disease management and post-acute discharge monitoring is one such disruptive innovation...The effective application of in-home technologies leads to increased medication adherence, reduced avoidable post-acute complications, and improved self-care management of chronic conditions. The net result is a potential annual savings of 20 percent or more – a $400 billion savings to the U.S. health care system."
It is clear that the National Health Information Network will now be multi-dimensional and responsible for integrating a variety of data/information movements. Patient care has always been a core component as data is exchanged between providers on chronic and episodes of care. Now, two other dimensions on the NHIN have come into clearer focus nationally and have long been proposed on this site. First, JACHO has proposed the "quality" dimension of the NHIN which in reality is the seamless integration of quality data collection and reporting into the patient care model as well as the service oriented architecture of HIEs, RHIOs and reporting requirements to states and federal government.
We've long promoted the belief that the infrastructure and changes in healthcare would be typical of many existing and developing business concepts. In some instances researchers have taken notice but it has been slower on the up take than expected, especially in those localities that could use that expertise. Last year a Harvard Business School professor focused attention to the system re-engineering potential. Now the Harvard Business Review includes an article on the potential of RHIOs as a comparison to the 90's B2B organizations. Only begins to scratch the surface but hopefully this will encourage others into the mix.
University students at Kansas State University, University of Kansas, University of Missouri at Kansas City, Rockhurst and Park University will again compete in the Cerner software development experience. The semester long competition will allow approximately 15 groups of near graduation or graduating information system, computer science, biomedical engineering and business majors to develop a targeted product along with marketing and support materials. These materials will be presented to top executives of Cerner at the end of the semester who then selects the winner in each category.
Patient safety is the target of this semester’s activity as well as cost containment and reimbursement protections. Costs are available in each area and beginning in late 2008 some will result in loss of reimbursement. Two projects are the primary focus: Health Predication Dashboard and Perioperative Dashboard.
Great presentation from Helen Haskell of Mother's Against Medical Errors who presents the case of her son and directly addresses needed changes as well as questions from an audience of providers. The presentation was given to the 2007 Quality Colloquium.
Presentation Link: Health Care Conference Administrators, LLC
Web site: Mother's Against Medical Errors
You know "innovation" has over stayed its welcome as the buzzword of choice when IBM, a champion buzzword-slinger in its own right, starts poking fun at all the mind-numbing blather on the subject. In one IBM ad, the spunky leader of an "innovation meeting" declares that the company is "100% committed to facilitating a culture of out-of-the-box, goal-oriented, value-added, disruptive, Web 3.0 ..." at which point an attendee who's keeping score of the buzzwords blurts out "Bingo!"
Several technology trends have appeared as significant to impact typical organizations. These trends are listed on http://blogs.techrepublic.com.com/hiner/?p=595&tag=nl.e138 and some are of particular interest to healthcare. In particular:
1. Half of business travelers won’t take their laptops
2. Open source will penetrate 80% of enterprise software
3. A third of all software purchased will be by subscription
4. Many new businesses will buy IT infrastructure as a service
5. Power efficiency will become a key criteria in IT purchases
Let sustainability begin.
Telecom bundling of information services and bandwidth has been a potential component of successful deployment of aggregate services in the NHIN. AT&T, Tennessee and a third party interoperability vendor (Covisint or could be any other capable vendor such as AXOLOTL) have formally announced the effort which shifts a lot of the responsibility to make content available to Tennessee's healthcare providers to AT&T's ability to offer a needed service at an affordable cost. To do so AT&T will be fronting the work of their third party HIE vendor, offering customer service, etc. much like they do now in their residential and business bundling tiers. While it could be pushed to identify a transaction level costing it sounds as if a monthly charge will be used between $3 and $100 to push/pull data from the exchange. Obviously a portion of those funds will be used by AT&T to insure the third party service is run correctly and sustainable, thus one of the most pressing problems facing NHIN on RHIO/HIE sustainability and business model is pushed to AT&T. AT&T has the funding base to take on the risk and the marketing/customer service infrastructure to make sure word gets out to potential customers. Healthcare providers get an affordable cost but more importantly get confidence that their exchange can be sustained with "real" dollars versus the come and go of federal/foundation funding.
The following article was contributed by a vet in Kansas who can clearly demonstrate the hours (days) lost in recognizing potential issues that might enter the human health system.