Month: July 2009

“Meaningful Use” – Tale of two words in Healthcare


Meaningful Use – That is it, those are the two words that is stirring up the healthcare providers, consultants, vendors,
lobbyists, bloggers, analysts in the US healthcare industry.

Its interesting to see a take on these two words after their new life as part of the HITECH (Health Information Technology for Economic and Clinical Health Act) investment act part of ARRA (American Reinvestment and Recovery Act), a stimulus plan for US recovery.

Who gave new life to this words: Department of Health and Human Services in US, who is going to be doling out ~30 billion USD in financial incentives for the adoption of electronic medical records in provider’s care infrastructure as part of the HITECT act, which is part of ARRA.

What caused the stir: HHS stated that funds will be distributed through Medicare and Medicaid incentive payments to EPs, physicians, and hospitals who are “meaningful EHR users.”

What “Meaningful Use” means and how do you define whether a doctor/provider is using technology in a meaningful way. Well that was the first reaction
of everyone in the industry. That was quite the sticker shock for getting money from the feds!

For example if I am using a car to drive to work, am I having a “Meaningful Use” of the car ? If I look from my perspective, of course yes, the meaningful use is Transportation. If you try to look from an environmentalist perspective, of course I am not a having a “meaningful use” of our planet by polluting it with my car.

That’s the way everyone involved in the US industry is looking it from their perspective and having war of words with it.
Here are some reactions in the industry:

From my friends at Medseek, they looked at it from the users(patient’s) perspective. Anything done in the name of tax payer’s money better be of “meaningful use” to the citizens.
http://medseekblog.typepad.com/medseek_weblog/2009/05/two-words-that-have-changed-healthcare-forever-meaningful-use.html

From Clickmark Research
outlook

On June 16th: HHS came up with a definition, which you can read here
http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113_872720_0_0_18/Meaningful%20Use%20Preamble.pdf

Quote from HHS “We recommend that the ultimate goal of meaningful use of an Electronic Health Record is to enable significant and measurable improvements in population health through a transformed health care delivery system”

The key words are “population health”. The definition of “meaningful use” is still in draft phase and it will be interesting to follow
how the HITECH investment act follows through to achieve improvements in population health while balancing the competing goals of healthcare providers.

Improvements in population health is key in terms of managing chronic diseases like diabetes, heart disease, COPD, asthma etc, which
is the key focus both in Canada and US.

More on “Meaningful Use” later…have a meaningful rest of the week and weekend that follows.

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healthcare…once upon a time!


“Once upon a time, going to your doctor was simple. You knew his first name, or perhaps just called him “Doc.” He lived just down the street and made house calls. And if you were sick, you would see him that day, because, well, you were sick” … that’s how the story starts for Hello Health! (founded by an American and Canadian in NY)

Hello Health attempts to make healthcare simple and accessible to patients and promises  to taking medicine to its basics.  With Hello Health, you can interact with your doc in your favourite means of technology.  If you have query and you would like to just e-mail, you just e-mail and its Free!  You make your appointments online and access your records as well.

At the primary care level, as the first point of contact for the patients, accessibility and responsive care is crucial for patients and especially for patients with chronic diseases like diabetes, cancer, heart disease and COPD.

So is Hello Health disruptive ? Absolutely in private healthcare market like US, its bringing the medicine back to basics and attacks the complex payer/physician centric model.  In market economics, as the value propositions of the consumers change, new players emerge to provide the missing value and this is often called as invisible hand and works in most cases. It remains to be seen whether it will work in healthcare.

Can a service like Hello Health, work in a single payer system like Canada ? Of course, it can, provided it meets the regulatory requirements of the government and the docs adopt the government certified EMR

Hello Health!
Hello Health!

(Electronic Medical Record), of course with lots of incentives.

Accessing a primary case physician is  relatively easy (caveat: if you have a family physician) in the Canadian Healthcare system and every one is aware of the improvement needed in terms of technology adoption.

In US, the question remains whether the proposed mandatory legislation by Obama administration can hinder a service like this. Boston Globe has a good coverage on this. http://bit.ly/WE67p

Also this type of pay for use service only serves the basic healthcare needs and Can it fix the completely ailing US healthcare system, where complex care consumes most of the resources in the system ?

It remains to be seen and the quest for solving the healthcare puzzle continues.

Benefits of e-Health system: good coverage by CBC


eHealth Portal - potential benefits

Good coverage on CBC this morning, with a series of videos on what does it mean to have an electronic access to healthcare information for patients, family members and care providers (clinicians).

Please check out the metro morning reports at CBC’s website

http://www.cbc.ca/toronto/features/marywiens/ehealth.html

So what made the CBC and its talented reporters to focus on what e-Health means to the Canadian public ?

As stated in the CBC‘s website this specific feature on collaborative nature of the technology “e-health portal would allow family members to not only see their lab tests on line but to share the information with each other” , is key piece to puzzle in managing chronic diseases in this province.

That’s BANG ON. As consumers we collaborate online using facebook, myspace, twitter, linkedin etc., and we are limited to do the same when it comes to our own healthcare as the data needed lies with in the walls of hospitals, clinics, doctors offices and most of it in PAPER.

Kudos to CBC! on expanding the horizons on e-health coverage and educating the public on what this could mean to Canadian citizens and especially their loved ones, who are suffering from chronic diseases like diabetes, COPD, cardiac related illness or cancer.

As I heard on the CBC radio one this morning, chronic diseases requires discipline in management from the patient and care provider and a colloborative portal absolutely benefits by increasing the efficiency of the care plan catered uniquely to each patient.

I cannot agree more and there are pilot projects that were executed in Ontario, Canada by various family health teams and Ontario Telemedicine Network to prove the clinical outcomes.