Health Semantics 101: "Cure" vs. "Heal"

It's challenging to explain to people in my family what I do for a living.

God love 'em, they do keep trying to understand.

Conversations about healthcare innovation and reform range from the dangers that result from penultimate our fear of dying (with grandmother Muz) to the dangerous spending patterns of our nation as a whole.

My sister Kate is now fond of saying: "Hey Jenny, can you hurry up and save healthcare already?" or, alternately, "Jen - Who killed healthcare?"

Recently several folks in my family joined Twitter to track work/life escapades, and communicate where we are (no matter where in the world we've landed) on any given Sunday.

Although I've found tweeting excrutiatingly valuable for work, I didn't expect family presence on Twitter to demonstrate professional relevance quite so quickly

After HealthCampPhilly (Saturday), my mom (@susanmccabe), who is a behavioral health nurse (going on +10 years now), saw a tweet I posted about 'cure' vs. 'heal.'

She left me this note in response:

"A cure is an expected, narrowly defined destination. Healing is a journey with unexpected twists and turns.

For a cure, the provider's role is pass or fail.

As a part of healing, the caregiver accompanies the patient on their journey, meeting them where they are at any given time, and having a supportive role even to the end.

There's always hope for healing."

-Susan McCabe, RN, 3.29.09

 

Do you see a doctor, go to a hospital, because you expect to be CURED or because you hope to HEAL?

My belief? A 'cure' happens to you. But healing is a process in which you, the person-who-is-also-a-patient, are the primary participant.

Yeah. This is all just wordplay.

But language matters, especially when we're talking about the little things like, oh, life and death. Healing and hope.

 

Which process, curing or healing (both? neither?), do you feel is within your scope of control to manage?

Or do you feel locked out of participation in either?

 

 

 

Posted via web from Jen's posterous

"Singing" Bacterium, Swimming Algae - What a Wonderful World...

"...Recent observations of Synechococcus using atomic force microscopy show these creatures having tiny spikes or spicules that extend from the cell's inner membrane, out through a crystalline outer shell and into the surrounding water.
Ehlers and co propose that these spicules can be made to vibrate by molecular motors within the cell and that this vibration causes nearby fluid to flow, generating movement (a phenomenon called acoustic streaming).

In effect, the bacteria "sing" themselves along."

 

MIT Tech Review: http://www.technologyreview.com/blog/arxiv/23214/?nlid=1890

 

Posted via web from Jen's posterous

Posterous #1 Tool Helping Me Share "Peeks" (Pronto) Into Healthcare, Science, Tech

Forgive my usual lack of eloquence, dear reader: this post is a quick and dirty story about getting results, and how Posterous has helped me do that.

Background: I've had a Posterous account for just over 2 months.

Since January 22nd, I've posted here 66 times. I have a tight crew of 15 subscribers, but have generated over 722 pageviews.

Q2 I'll begin tracking my sticky web of views from Posterous-generated content via Google Analytics (how many views on Twitter, Facebook, HMRx, and Posterous combined?).

My Posterous posts now generate roughly 300% more views of "Jenstream" content PER POST (thanks @tedeytan, @epatientdave for the nomenclature) than my Blogger-hosted site, Health Management Rx.

HMRx has been active for over two years this April. That's a LOT of time spent formatting/reformatting articles, finding interesting links and emailing them to myself, to drive an mean of between 30-90 views per posting day. Ouch. 

Posting at Posterous takes me an average of 15 mins, and the content I provide here is automagically pushed to my Facebook wall, forlorn and limping HMRx blog, and, far more importantly for my current projects - my Twitterfeed (@jenmccabegorman).

Pre-Posterous, if I saw a news article, blog post, etc. I thought worth sharing, I'd have to copy and paste the URL into an email to myself (jennifermccabegorman@yahoo.com), with a summary sentence (so I didn't forget my train of thought) and a few graphs on why it was important for healthcare innovation.

Then this usually sat in my inbox indefinitely awaiting action, unless I put a day/date/time tag on it with an obnoxious all-caps note to self BLOG THIS ASAP!

You can probably imagine how well *that* method worked out, and how many good meaty links ended up in the 'trash' section of my Yahoo mail account.

Then, once I finally decided to blog an item, posting at HMRx took me an average of 45 mins.

I could set the kitchen timer by this, and usually ran over and had to allot an hour to post via Blogger. What a pain in the a@#!

What does all this tell me? And why should you care?

It's this simple: Posterous works. It is the most effective tool in my significant cloud-based tech arsenal for spreading rhizomatic content, opinions, and links.

When I first took a look at Posterous, I wondered what possible value I could derive from, sigh, ANOTHER blogging site.

Then @garrytan told me about the autopublish function, and the sun broke through the clouds.

Holding hands with Twitter, Posterous let's me deliver a 1-2 punch of content - short and sweet? Tweet. Slightly more complex production? Posterous.

I'd pay for Posterous guys. It's not a blogging site. It's a complete self-to-content transition platform.

I'd pay more for Posterous than my Pro Flickr account.

Photos, after all, get me viewjoy and some small sense of relatively artistic accomplishment, but Posterous gets my professional life moving at warp speed.

Thank you, and keep up the great work. Yes. You haz a fan.

 

Posted via web from Jen's posterous

"Why I Quit Google" & Power of Design -Goog's Former Top Designer Doug Bowman

 

From Silicon Alley Insider

"Seven years is a long time to run a company without a classically trained designer. Google had plenty of designers on staff then, but most of them had backgrounds in CS or HCI. And none of them were in high-up, respected leadership positions. Without a person at (or near) the helm who thoroughly understands the principles and elements of Design, a company eventually runs out of reasons for design decisions. With every new design decision, critics cry foul. Without conviction, doubt creeps in. Instincts fail. “Is this the right move?” When a company is filled with engineers, it turns to engineering to solve problems. Reduce each decision to a simple logic problem. Remove all subjectivity and just look at the data. Data in your favor? Ok, launch it. Data shows negative effects? Back to the drawing board. And that data eventually becomes a crutch for every decision, paralyzing the company and preventing it from making any daring design decisions."

 

http://www.businessinsider.com/why-i-quit-google-2009-3

Posted via web from Jen's posterous

Checking out the MEDgle Search Engine...

Posted via web from Jen's posterous

Try this code in your blogging software to play with the widget (via Ash Damle-thanks Ash!):

or:

<html>

<body>

<link href="http://www.medgle.com/cmsstyle.css" type="text/css" rel="stylesheet"/>

<script src="http://www.medgle.com/widget.js" type="text/javascript">script>

<script>writeMEDgleWidget('test');script>



body>

html>

Read more: "Checking out the MEDgle Search Engine... - Jen's posterous" - http://hmrx.posterous.com/checking-out-the-medgle-search-engine#ixzz0AUt30yJl

"The Most Personal Device" by Doc Searls

Part I in an elegant case for codifying our online IDs as legally transferable assets: "As creatures, we humans are distinguished not only by our intelligence and use of language, but also by two other remarkable characteristics: our mobility and our expansiveness. We are relatively hairless and walk on two feet because we are runners. A well-conditioned human can run indefinitely. We also expand our very selves though [sic] the things we invent, hold and manipulate. Our senses spread out through our clothes, our tools and our tech by a process called indwelling. When drivers say "my wheels" or pilots say "my wings", they mean it personally. The perimeters of our selves are not bound by our bodies. They extend to include the tech we use. To become expert is to enlarge ourselves, whether as carpenters, drivers, pilots, or whatever." - Doc Searls is Senior Editor of Linux Journal. --I picked up my March 2009 copy at #sxsw, where I also rode from the Austin airport to my hotel sitting next to Doc for 20 mins. Doc helped us launch Nexthealth.NL on the backchannel at MoMo in Amsterdam last spring. ---Doc - let me know how in health VRM can help us make "patient" and "provider" seem as antiquated as "mainframe" and "minicomputer."

Posted via email from Jen's posterous

Genoanth Update: Female Finches Judge Genetic Match, Pick Sex of Eggs

A very special friend sends me this: http://news.bbc.co.uk/2/hi/science/nature/7953467.stm My response (of course): http://www.lyricsdatabase.gen.tr/365346/Man_Smart,_Woman_Smarter.html Watch the entire video with streaming lyrics.

Posted via email from Jen's posterous

How Docs Will Get Paid in the Future: A "Cash-Only" Primer

"Will the current economic climate continue to increase the number of physician who go cash-only? Seven out of 10 respondents to a MedPage Today online spotcheck think so." Sitting with Dr. Jay Parkinson of Hello Health (@jayparkinson) and Jonathan Sheffi (@sheffi) munching tortillas in the sun last week at #sxsw, the three of us engaged in some verbal wrestling about how docs will be paid in the future. My vote for reimbursement (one of them anyway) is to create a new class of DRGs (or ICTs on the WHO stage) and CPTs that pays docs for emedicine, telemedicine, and mHealth interactions. Jay shot me down, saying cash payment is the way to move forward. Jay would know, since this is the model Hello Health is using. While I agree with Jay that cash-only will be a primary restructuring tool for rebuilding the US healthcare system, I also haven't completely given up on the fact that we'll need to integrate BOTH revolutionary (cash only) + traditional (coding) methods of payment to ensure BOTH types of docs (revolutionary) + (traditional) are paid to interact with me as a patient where I live and work and play (online, in the cloud, on my mobile).  For now though, let's focus on some of the basic aspects of cash-only practices. Rejoice! After reading this Posterous you too will be able include this kind of commentary in your stunningly interesting cocktail-party healthcare reform banter. Just don't be surprised if your companions retreat to nebulous talk about environmental issues or how much the economy stinks... All items in quotes below are from a MedPage Today article:http://www.medpagetoday.com/PracticeManagement/PracticeManagement/13347?utm_source=mSpoke&utm_medium=email&utm_campaign=DailyHeadlines&utm_content=GroupB&userid=172629&impressionId=1237516300840 How many cash-only physicians are there? Good question. "according to the CDC, in 2005-06, 11% of physicians had no managed care contracts." Are cash-only physicians concierge practices? Good question. Not necessarily, although cash-only physicians may ALSO operate a concierge like service... "Cash-only physicians don't operate like concierge practices, said Jeffrey J. Denning, a practice management consultant in La Jolla, Calif. "Concierge practices charge an annual membership fee of $1,000 or so for increased access to the physician in an upscale office environment, then bill insurance companies or Medicare for services. Nothing much changes in a cash-only practice except getting out of the insurance billing business." How do docs get paid in a cash-only practice? At the point of service, via cash, although many will also accept checks and credit cards (MedPage recommends having staffers who handle the moolah 'bonded.' Funny. Do we bond retail store cashiers? Why would staffers at a medical practice be MORE likely to embezzle just because they haven't handled large amounts of cash at a docs practice?) Many things in medicine are NOT simple. This is one thing that IS. Hope we see more cash-only practices. How do docs figure out how much to charge in a cash-only practice? Like any other small business. No, seriously... "Like most small-business operators, cash-only physicians look at what competitors are charging, calculate the cost of doing business, then tack on enough to make a profit. Dr. Berry said he strives to keep fees "between the cost of an oil change and a brake job." Starting a cash-only practice forces docs to operate in a more business-like manner in other ways: "Physicians who drop third-party contracts typically have to advertise their practices until word-of-mouth kicks in. " Why would docs want to operate a cash-only practice? "Because cash-only physicians have lighter workloads than their peers, noted Judy Capko, a consultant in Thousand Oaks, Calif., they're better able to build strong healthcare partnerships with patients. Patients, in turn, have easier access to care and are less likely to experience the rushed appointments that result when physicians see large numbers of patients to compensate for managed care's low reimbursement rates." As a matter of fact, the cash-only practice model is so simple and intuitive I'm surprised it hasn't yet come under fire by the AMA or others looking to protect the current reimbursement way of life. Doc-run and specialty hospitals (operating as, say, cardiac specialty centers) have been slammed by organizations (with big lobbying budgets) looking to protect the status quo. Accusations that these specialty hospitals get to 'cherry pick' the best patients abound. I can definitely see the potential for cash-only docs getting whacked with the same sideways argument - "Cash-only docs can pick the 'healthiest' or 'best' patients, those who have cash out of pocket to spare, either because they're healthy or wealthy, leaving the 'sickest' patients covered by insurance to seek care elsewhere." Even the MedPage article falls for this one: "The flip side of this, of course, is that cash-only patients must dig deeper into their pockets than patients who only need to fork over a copayment. " First of all, who keeps cash in a pocket anymore? Second, cash-only docs aren't picking the healthiest patients, but the healthiest patients may indeed begin to pick cash-only docs. Wrap your mind around that one for a few...

Posted via email from Jen's posterous

New Medical Condition(s) for DSM V - "Southby'd" and "Southbabies" (#sxsw)

 It's a long travel day (12+ hours) from Austin, TX back to DC.

Travel snapshot: At the Charlotte airport a mulberry-haired Japanese woman in a strawberry pink hoodie is holding a large chihuahua as if that baby canine is the Holy Grail.

I'm sitting by a power outlet, plugging back in - mentally digesting my first SXSW experience and realize there is no easy way to describe this letdown.

One of my favorite things about Southby was the unexpected wordplay that results when you meet other geeky tech folks. Crowdsourcing new verbology at #sxsw is one of the least expected but most interesting side benefits of hanging with such a professionally diverse crowd in Austin.

My favorite term (before this afternoon) is from the soc-anth school. In the hallway talking about parties, a new friend suggested the noun "southbabies." This tags the, ahem, interesting crowd interactions between males and females at parties during SXSW, as in "some southbabies are gonna be made after this one."

In a slightly more professional vein, I'm proposing a term to catalog the feeling of getting hit with the #sxsw whammy after the event - "southby'd."

You can use 'southbyd' as a noun (I feel southbyd) or a verb (I'm gonna Southby you if you don't show up at the Google party!)

south⋅by⋅d/ˈlɛθərdʒi/ Show Spelled Pronunciation

[sowth-bi-d]

-verb, noun

1.

the quality or state of feeling listless and unenergetic following attendance at the annual SXSW Film, Interactive, and or Music festivals in Austin, TX. Grade I experienced after attending one subfestival, Grade II experienced after attending two subfestivals, Grade III experienced after attending all three subfestivals. Grades I and II often require 24-72 hours of bed rest. Grade III may require hospitalization, IV fluids.

2.	Pathology. an abnormal mental state or disorder characterized by overpowering laziness, hunger, and lack of initiative following attendance at #sxsw. Common usage: "Man, I'm so southbyd, I need a large Texas Breakfast with biscuits and gravy stat, and then I'm taking a three day nap."

---

2009 (March); < Gk lēthargía, equiv. to ltharg(os) drowsy + -ia -y ³ (see Lethe, -algia ); r. ME litargie < ML litargīa < LGk, Gk, as above
Based on the Random House Dictionary entry format, © Random House, Inc. 2009.

Origin:

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Explore the Visual Thesaurus »

Related Words for : southbyd

conference exhaustion, event hangover, 

Additional ethnographic info: From urban anthropological English+semantic web/event-contextual hybrid. Condition one experiences after attending #sxsw in Austin, Tx. Symptoms: lethargy, throbbing, blistering pain in lower extremities due to walking (often in inappropriate footwear for females), driving hunger for simple carbohydrates, particularly starches such as those provided by papas fritas. Strange cravings for McDonald's Egg McMuffin may be experienced, often between the hours of 11am-3pm EST.

 

Abbreviation: southbyd

 

 

Posted via web from Jen's posterous

Social Networks and Health at #sxsw

"When I was in the hospital to have a hip replacement I thought I was going to die from a medical error...so I thought if I blogged there would at least by an audit trail..."

-67 year old female audience participant, cross-legged on the floor, room 5B #sxsw

Posted via web from Jen's posterous

Last Batch: Tweets - Nominees Must Send Resumes TODAY!

Tweets - if you nominated someone (seriously) please do the following TODAY:

1. let them know

2. see if they're interested in submitting a resume for review (willing to serve? seriously considered?)

 

If so, have them forward CV/resume (or link to resume stored in Google docs) to me at: jennifermccabegorman@yahoo.com or jmccabegorman@organizedwisdom.com.

I will submit resumes forwarded to me with a cover letter of recommendation, but the whole shebang is DUE TOMORROW.

 

THE DEADLINE IF YOU WANT ME TO SEND IS TODAY by 5pm EST.

 

Nominations from ekivemark:

@tedeytan

@jenmccabegorman

@ryantarzy

 

Nominations from @john_chilmark:

Vincent Cerf

P(eter).Neupert (Microsoft)

J(onathan). Bush (Athena)

A(dam). Bosworth (Keas)

P(aul).Levy (BIDMC)

 

Nominations from @tstitt:

Kieran Lal, Drupal.org Board Member, Acquia.com Community Guide, http://cli.gs/N8vdtW

 

Nominations from @sjdmd:

Craig Feied, now of MSoft

 

Nominations from mindofandre:

@jimtate

@caparks

@robert_hendrick

@jenmccabegorman

@bobcoffield

 

Nominations from leonardkish:

JD Kleinke http://www.speaking.com/speakers/jdkleinke.html

 

Nominations from @bobcoffield::

Jane Sarasohn-Kahn, Health Economist, Health Populi

Christopher Parks, CEO of change:healthcare

John D. Halamka, MD, MS, CIO CareGroup Health System, Chief Information Officer and Dean for Technology at Harvard Medical School

Scott Shreeve, CEO ofCrossover Healthcare

Josh Lemieux, Markle Foundation

Jay Parkinson, MD, Hello Health

Jen McCabe Gorman, Health Management RX

Matthew Holt, Health Care Strategist and Co-Founder, Health 2.0

Jonathan Bush, CEO of Athena Health

Peter Neupert, VP Health Solutions Group, Microsoft

Roni Zeiger, MD, Product Manager, Google Health

Enoch Choi, MD, Partner, Palo Alto Medical Foundation, MedHelp.org

Marty Tenenbaum, Health 2.0 Accelerator Visionary

David Kibbe, Senior Advisor American Academy of Family Physicians

Amy Tenderich, Writer, Blogger, Consultant, Patient Advocate www.DiabetesMine.com

Adam Bosworth, CEO of Keas

Sarah Chouinard, MD, Community Health Network of WV

John Wiesendanger, CEO of West Virginia Medical Institute, Inc.

 

Posted via web from Twitter Nominees for DEPARTMENT OF HEALTH AND HUMAN SERVICES

Third Batch - Keep Em Comin'

Nominees from @jeanneendo:

@accarmichael

 

Nominees from @mindofandre:

@jimtate

@caparks

@robert_hendrick

@jenmccabegorman

@bobcoffield

 

NOTE: Final submissions for nominees (letter of recommendation + resumes) are due March 16th.

I'll contact nominees listed on this Posterous by March 15th.

If they're interested, they can send me a copy of their resume, a link to their LinkedIn page, bio in Google docs, etc. I'll write up a summary letter to include explaining how this went down.

Alternately, nominees who perk up as a result of being nominated by the Twitterverse may send their information directly to:

ADDRESSES: Office of the National
Coordinator, Department of Health and
Human Services, 200 Independence
Avenue, NW., Washington, DC 20201,
Attention: Judith Sparrow, Room 729D.
E-mail address:
HIT_FACA_nominations@hhs.gov.
Please indicate in your letter or e-mail
to which Committee your nomination
belongs.

FOR FURTHER INFORMATION CONTACT:
ONC/HHS, Judith Sparrow, (202) 205–
4528.

Posted via web from Twitter Nominees for DEPARTMENT OF HEALTH AND HUMAN SERVICES

Second Batch - Do You Know Someone You'd Want Working on National Health IT Policy in DC?

Nominees from @JustinHerman:

@sarahrahpark

Nominees from @Robert_Hendrick:

@jenmccabegorman

 

Leave their name in the comments. DM @jenmccabegorman or @bobcoffield on Twitter.

Or just toss it out there on Twitter with hashtag #nominateHIT.

 

All it'll cost you is 140 characters...

Posted via web from Twitter Nominees for DEPARTMENT OF HEALTH AND HUMAN SERVICES

brightkite.com

via brightkite.com

Prepping for #sxsw and happened upon all kinds of useful communal links, this one a streaming backchannel from Brightkite.
C:\Users\Niffer\Desktop\data liquidity in healthcare should be this easy 3.12.09 prepping for SXSW.png

Data liquidity in healthcare should be this easy....(similar backchannel for break areas, meal areas, Starbucks in hospital cafeteria, preop registration/waiting area).

Posted via web from Jen's posterous

Drumroll Please...First Batch - Who Would YOU Nominate?

Nominees from @gfry

@tedeytan

@ePatientDave

@jenmccabegorman

@scottshreeve

@jayparkinson

@carlosrizo (if non US ok)

 

Nominees from @Sarahrahpark:

@cmschroed

 

Nominees from @jenmccabegorman:

@tedeytan

@carlosrizo

@jayparkinson

@caparks

@accarmichael

@symtym

@AllergyNotes

@disruptivewomen (for the 'pack' potential)

@philbaumann

@sciencebase

@healthythinker

@SusannahFox

@KittKlaiss

@bobcoffield

@epatientdave

@floatingbones

Posted via web from Twitter Nominees for DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Twitterstorm for a Cause: Nominate the Best HIT Policy Tweets You Know

<html><body><div><iframe name="POSTEROUS___bookmarklet_iframe" id="POSTEROUS___bookmarklet_iframe_id" style="border: 0px none; margin: 0px; padding: 0px; width: 100%; height: 100%; opacity: 1; overflow-x: hidden;"></iframe>

via edocket.access.gpo.gov

http://edocket.access.gpo.gov/2009/pdf/E9-5391.pdf

@bobcoffield asks: Who would you nominate?

GOAL: Vote on potential nominees and then submit the list of top votes - twitter/social media at work in Government 2.0.

YOUR MISSION: Create list of nominees for DHHS -

1. Office of National Coordinator for Health Information Technology (eg Grand Poobah of HIT)

2. HIT Standards Committee

3. HIT Policy Commitee

TO POST: DM @jenmccabegorman or @bobcoffield to be added to contributors' roster for this Posterous, or DM/tweet your nominees.

OUR DEADLINE:
March 15th. Let's get cracking people.

Posted via web from Who Should Run HIT on the Hill? Twitter Nominees for DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Twitterstorm for a Cause: Nominate the Best HIT Policy Tweets You Know

via edocket.access.gpo.gov

http://edocket.access.gpo.gov/2009/pdf/E9-5391.pdf

@bobcoffield asks: Who would you nominate?

GOAL: Vote on potential nominees and then submit the list of top votes - twitter/social media at work in Government 2.0.

YOUR MISSION: Create list of nominees for DHHS -

1. Office of National Coordinator for Health Information Technology (eg Grand Poobah of HIT)

2. HIT Standards Committee

3. HIT Policy Commitee

TO POST: DM @jenmccabegorman or @bobcoffield to be added to contributors' roster for this Posterous, or DM/tweet your nominees.

OUR DEADLINE:
March 15th. Let's get cracking people.

Posted via web from Jen's posterous

Dr. Stanley Feld = My Healthcare Czar

"Consumer driven healthcare is the only thing that can repair the healthcare system. It would take control out of the healthcare insurance industry’s hands. The route to take is the ideal medical saving accounts. The government should act as the facilitator for the competition. The time has come for politicians to do something for consumers and not for secondary stakeholders."

From: "Repairing the Healthcare System."
http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/

Dr. Feld is required reading for health folks (and health-curious types too).

Posted via web from Jen's posterous

Los Alamos researchers create 'map of science'

via physorg.com

From Physorg.com.

Notice on the far lefthand side that dermatology and social work have an equal number of nodes.

Note also the web that flourishes between nursing, psychology, etc. View the relative isolation of public health, and the overlapping cluster that is clinical pharmacology.

Visualization at its best. Funny how these images stop us from running in circles to figure out where we need to connect next (puns fully intended).

Posted via web from Jen's posterous

This is Your Brain on...First Impressions

via psychcentral.com

From: "Brain Response to First Impressions | Psych Central News"
http://psychcentral.com/news/2009/03/09/brain-response-to-first-impressions/4612.html

Posted via web from Jen's posterous

Open Economics - Opensource Goldmine for Quant Geeks

Check out this website I found at openeconomics.net

Where else can you peruse, at your leisure, the current Bank of England Interest Rate, or CIA World Factbook data? Or gold prices since 1950?

Hope someone adds some healthcare related datasets soon...

Posted via web from Jen's posterous

Harris Poll: "Little or No Progress Changing Unhealthy Lifestyles"

via harrisinteractive.com

Consumer-centric care. Participatory medicine. Enabled by eHealth platforms, mHealth apps. Nuff said.

Posted via web from Jen's posterous

The End of Life Care Discussion - Have It

"If half of the estimated 566,000 American adult cancer patients who died in 2008 had the end-of-life discussion, the projected savings would conservatively be $77 million, according to a report published in the Archives of Internal Medicine."

Posted via email from Jen's posterous

How Much $ Will Get a Doc to Change Practice Procedures?

Apparently, it's more than the $1500 to $2000 range... "Most of the medical groups surveyed in the study reported that the program's financial incentives -- generally about $1,500 to $2,000 annually per physician -- were too small to stimulate significant change among most doctors. How much will we have to pay docs to adopt EHRs and integrate PHRs? Two to FIVE TIMES more, according to a recent RAND study. I'm no good at math, but that's 4-10k. PER DOC. The Obama Administration and DHHS Sec. nominee should take a good look at these figures...suddenly I'm worried the 19-21B earmarked for HIT may not be enough. What else do docs want? Choice. "The authors said these problems might be diminished if doctors felt they had more autonomy in implementing the programs." It's about time somebody gave it to them.

Posted via email from Jen's posterous

Yes, We Heart Our Robots...

via washingtonpost.com

"Robots, Which Now Perform Medical Tasks, May Learn to Provide Therapy, Support" by Anita Slomski.

Yes. We heart our robots.

Interesting how new tech creates new breeds of relics.

We try to keep even the latest technology tied to our physical identification of self...it took me a year+ to give up my first iPod Shuffle even though it was having 'issues.'

Wonder if we also heart medical devices? I'd be interested to know how many of us 'keep' medical devices that are removed/used.

I *hate* with a passion the rocking chair I had to use for knee rehab after my accident, and got rid of it.

However, I kept a piece of my Helvetica ex-fixator and a long screw with a bit of bone fragment. Gross, yeah, probably.

But that screw helped keep my life together, via the ankle bone(s), as it reknitted around a new skeletal framework. It deserves a place on the shelf, don't you think?

Posted via web from Jen's posterous

Wired Docs - We Need More of 'Em

via news.cnet.com

"This is literally the patient point of view...It is a photo from my doctor's waiting room."

Great piece on CNet about consumer concerns re: how the stimulus funding will be spent (or blown).

Posted via web from Jen's posterous

Pharmas Nudge Semantic Web Technology Toward Practical Drug Discovery Applications | BioInform | Informatics | GenomeWeb

Slater and his colleagues developed a type-2 diabetes ontology as well as other ontologies to support the system. Basically it is a triple store, with OWL ontologies over that, Jena on top of that, and Web services cover all of it so we can make calls into the Web services and get our data back, he said. The stack has a visualization layer and a dashboard listing the knowledge bases within Pfizer, which lets users create their own knowledgebases pointed to their own ontologies.

via genomeweb.com

Seems there are signs of life in the semantic HC web after all...

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Healthcare will be 1/5 of our GDP by 2015 (I'd bet on 2013)

Scary. Amazing. Listen. http://www.npr.org/templates/player/mediaPlayer.html?action=1&t=1&islist=false&id=98150829&m=98150819 NPR interviews Princeton Economist Dr. Uwe Reinhardt. I met Dr. Reinhardt 2 years ago at JCAHO's Hospital of the Future conference at Walt Disney World in Florida. It's a small world, after all... Jen McCabe Gorman Chief Patient Advocate OrganizedWisdom Cofounder: Nexthealth NL Health Management Rx Twitter:@jenmccabegorman http://www.linkedin.com/in/jenmccabegorman Skype: jenmccabegorman Blackberry: 301.904.5136 Dutch Mobile: +31655585351 jennifermccabegorman@yahoo.com

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Letters From Beyond: LASTPOST Sends Your Postmortem Mail

via lastpost.com

After a fascinating Twitter discussion last week with @markhawker about creating a web-based service that would post notification of your death to your social networks (Twitter, Facebook, MySpace, etc), I stumbled upon LASTPOST.

For 29.99 pounds, you can send a letter to someone after you die. This is a fascinating idea.

As Mark and I tweeted, as the intimate details of our lives move to the cloud, so will notification of our death.

How can we try to preemptively reduce the shockwave ripples that strafe out through our online social linkages as a result?

Good question. But there's a definite need here.

I don't want my family to have to notify my Facebook friends, or my twitterstream, that I've passed away. I'd rather pay to have a service send my words directly, activated by a one touch button (or email) from a designated contact.

Now who's going to build something like this? LastPosterous?

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Want a Say in How EHRs are Certified? CCHIT Looking for Workgroup Volunteers

via cchit.org

CCHIT wants a new crop of workgroup volunteers.

If you're a health type who wants a say in policy, especially which EHR/EMR systems may get through to enjoy a share of stimulus-related funding, apply.

http://www.cchit.org/about/news/releases/2009/Certification-Commission-Plans-Work-Group-Recruiting.asp

Deadline: March 23, 2009

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EHR Vendors, How to Compete in the HITECH Age (Take a Page from AthenaHealth's Playbook)

via athenahealth.com

February 17, 2009...a day that will live in infamy...

From "What you need to know about the HITECH Act of 2009 : athenahealth"

Full read here: http://www.athenahealth.com/campaign/hitech/index.php

Last month President Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act into law.

The bill is part of the Stimulus package known as the American Recovery and Reinvestment Act.

Athena is proactively keeping up with potential requirements for reimbursable systems and provides some nuggets of wisdom here - also worth noting they believe their EHR, athenaClinicals, is ready and set to go when Uncle Sam starts writing those checks.

What you should take away from Athena's update if you're an EHR/EMR vendor (or about to become one by virtue of chasing the Great Stimulus Bill Carrot):

1. Get certified - the "smart" $ is on CCHIT certification...."there is general consensus that the certifying organization will be the independent Certification Commission for Healthcare Information Technology (CCHIT)."

2. IF you haven't yet started CCHIT's process, get rockin.' Be sure your platform has:

* patient demographic data
* clinical health information, plus;
* the capacity to provide clinical decision and physician order entry

Bivalve model anyone?

Oh yeah. And also toss in some e-prescribing capabilities.

3. Use your crystal ball, or some lobbyists and Clinovations-types to discern what HHS *might* be getting at when they say docs must demonstrate "meaningful use" of an EHR. Percentage of patients enrolled? Etc? Naw, don't worry, this isn't outcomes based - YET. The definition parameters for meaningful use at this point are capabilities-oriented and include:

* that pesky e-prescribing
* the ability to interchange data electronically (a la the interwebs people)
* the ability to submit clinical quality measures

Re: What constitutes 'clinical quality measures,' good guesses may include IHIs mandates, perhaps some JCAHO info, and payor oriented measures like PQRI, which, by the way, athenaClinicals has already integrated).

More on athenaClinicals here:
http://www.athenahealth.com/our-services/athenaClinicals.php

And CCHIT certification here:
http://www.cchit.org/certify/index.asp

Athena sums it up best here:

"The HITECH Act is clearly an ideal opportunity for physicians who use EHRs effectively to be rewarded and to stimulate adoption for those who aren’t currently using EHRs."

All aboard folks, or get left behind when defense contractors turn hungry eyes towards healthcare. Oh wait....

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Healthcare Folks - Protect the Hax0rs! They Heart You!

Check out this website I found at ascannerbrightly.blogspot.com

http://ascannerbrightly.blogspot.com/2009/03/medical-data-privacy-consumers-v.html

Amen.

Posted via web from Jen's posterous

Health Blog : Health-Reform Appointee Sits on Health-Industry Boards

via blogs.wsj.com

No conflict of interest? You're kidding me right?

"While we’re on the subject of health-care players’ ties to industry, we should catch up with news about Nancy-Ann DeParle, President Obama’s designee to run the new White House health-reform office.

She’s a board member of at three health-care companies likely to be affected by health reform: health information-technology company Cerner, medical-device maker Boston Scientific and pharmacy-benefits manager Medco. "

Deparle will step down from her board seats and also 'recuse herself from matters directly and significantly impacting the companies, an administration official told Politico.'

Cough cough, stimulus bill anyone, cough cough?

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CareFirst BlueCross BlueShield, Maryland Hash Out "Healthy Maryland" Universal Coverage Plan

via baltimore.bizjournals.com

Health types - it pays to read the local business press...

"Maryland now has two universal health care plans to cover more than 800,000 uninsured residents."

My own sweet MD next state to go for broke (literally, figuratively) with 'universal' coverage "Healthy Maryland" plan for the uninsured.

This could mean ME, if I don't move to Canada, Timbucktoo, or other points on the compass, as well as my father.

"It is unclear how businesses view Healthy Maryland, but talk within the health care industry suggests Maryland’s employers may not have to worry about it until next year. Annapolis insiders say CareFirst, Hammen and Middleton are floating the Healthy Maryland plan this year as a way to gauge lawmakers’ and the public’s appetite for the plan and to encourage more debate about health care coverage."

One thing to applaud (?):

"...officials of Owings Mills-based CareFirst said the region’s largest health insurer did not want to wait for progress to be made on the federal."

Insurers are afraid legislation will drive them to provide plans of this nature anyway, and are seeking the PR win via proactivity?

If you can't beat the bill, help draft the policy from the ground? And maybe those nice appreciative legislators will give you some tax breaks or something as a result?

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Accounting for Healthcare Expenditures - What $ Comes in Under the Radar? Micro Look at Community Hospital Stats

via smhwecare.com

National stats on how healthcare spending will break the American piggybank wide open are easy to find.

Let's take a micro-look at how healthcare costs, utilization, and budgeting are affecting small-town USA, and how even in the non-profit hospital space, significant monies flow in and out through various donation, gift, and other channels. Here's what keeps me up at night when I read the latest release about the stimulus bill budgeting...

Spending is never quite what it seems on the healthcare balancesheet, not from the individual perspective, and not from the systemic perspective.

Exhibit A: St. Mary's Hospital of Maryland. I worked there as a Patient Advocate my senior year of undergrad.

Quick disclaimer - I've also received excellent post-trauma care at the hospital, and still count that job as one of my favorite to date. Because it supports so many in my community (including most of my immediate family), I follow its activities from afar.

I just received their latest edition of "Healthy Living," a community-oriented print newsletter.

A quick and dirty read of the newsletter reveals these interesting stats about costs/expenditures we're counting (or not counting) in HC:

* breast cancer accounts for approximately 33% of all cancer Dx (and on the rise), leads to purchase of breast coil for one MRI machine, also new 64 slice CT scanner - where is condition-specific research influencing how we budget for healthcare acquisition of equipment, personnel, and thus incentives for R&D, training, recruitment, education, etc?

* volunteers (unpaid employees) donated more than 7k hours over past fiscal year, and made over 5k 'pastoral' visits...it's home health with a religions/faith-based bent, and is accounted for nowhere on the balance sheet - where's the DRG for this? By what percentage is our national healthcare spend REDUCED via volunteerism and donated time? How will the graying of the boomers, increased workloads, and rising sedentary lifestyles REDUCE future volunteerism in the healthcare space?

* The hospital's Annual Gala was sponsored by Wyle, Alliance Anesthesia Associates, AMEWAS Incorporated, Associates in Radiation Medicine, Eagan McAllister, IAP World Services, ManTech Systems Engineering Corp. This is smorgasboard of pharma, HC, and defense/contracting players (community-based since we live near Patuxent Naval Air Surface and Warfare base PAXRiver). Raises $175k for Foundation Scholarship program, aka recruit and pay for education of future employees. By what percentage is our hospital's ability to recruit INCREASED by gala/fundraising activities? How will this be affected by recessionary/depression related pressures?

* St. Mary's Hospital Auxiliary group raised $15,1000 for mobile EKG machine for ER (Aux. donated more than 4.3 MILLION in gifts since 1970). What percent of our hospitals' budget lines are raised by auxiliary groups? How do they contribute to HIT, EMR, etc. spending, if at all?

* According to 2005 data (!), 13.4% of people UNDER 65 were uninsured in St. Mary's County. A rise in the uninsured (and underinsured) populations affects spending how? What percentage of nonprofit assistance programs jump in here and contribute? How do we quantify that?

* For FY 2008 (1 July 07-30 June 08), the hospital provided more than 3M in 'charity care,' at reduced or no cost. How do increases in charity care provided affect the bottom line nationally?

* SCARY: "The hospital saw a 68% increase in individuals utilizing (not applying for, USING) the hospital's Payment Assistance Plan from fiscal year 2006 (!) to fiscal year 2007." A financial assistance counselor is cited as saying that "over the last six months she has seen an increasing number of individuals who fall within the middle-class designation (according to Federal Poverty Guidelines) requesting help. How will time spent with patients counseling them on payment alternatives change the face of daily business and operations at our hospitals? Will we outsource this? Do we quantify it?

In other words, how much is counseling people about how to pay for their healthcare REALLY costing us?

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