Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Health Care Provider Joint Venture Hopes To Bring Together The Best Of Each Company

Microsoft and GE Healthcare announced a joint venture last week (as-yet unnamed), trumpeted as bringing together the best of both companies’ offerings in the health care provider market. (More from the NY Times.) Late in the day, I spoke with Brandon Savage, Chief Medical Officer at GE Healthcare, and Nate McLemore, General Manager of Microsoft Health Solutions Group.  They had a great deal to say about the companies’ shared vision of the use of platform technology to enable care teams to deliver the right decision at the right time, noting that their core products complement each other rather than overlap.

The centerpiece of the collaboration will be an amalgamation (so to speak) of the two companies’ strengths around Amalga (the Microsoft product) and Qualibria (the GE product). Brandon and Nate described the challenges facing these products thus: Qualibria needs to be able to pull in data from multiple sources better (Microsoft can help), and Amalga needs to be able to share best practices across sites better (GE can help).

Put another way (to quote John Moore at Chilmark Research), Amalga is “more a toolset than a product.” McLemore acknowledged that Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

Changing Regulations To Give Patients Greater Access To Health Records

On September 14, HHS released for comment draft lab results regulations that will, if finalized, effectively bathe the Achilles’ heel of health data in the River Styx of ¡data liberación! All lab results will be made available to patients, just like all other health data.  (See the HHS presser and YouTube video from the recent consumer health summit.  Todd Park, HHS CTO, is also the chief activist for what he calls ¡data liberación!)

Forgive me for mixing my metaphors (or whatever it is I just did), but even though there are just a couple dozen words of regulations at issue here, this is a big deal.

When HIPAA established a federal right for each individual to obtain a copy of his or her health records, in paper or electronic format, there were a couple of types of records called out as specifically exempt from this general rule of data liberation, in the HIPAA Privacy Rule45 CFR § 164.524(a)(1): psychotherapy notes, information compiled for use in an administrative or court proceeding, and lab results from what is known as a CLIA lab or a CLIA-exempt lab (including  “reference labs,” as in your specimens get referred there by the lab that collects them, or freestanding labs that a patient may be referred to for a test; these are not the labs that are in-house at many doctors’ offices, hospitals and other health care facilities — the in-house labs are part of the “parent” provider organization and their results are part of the parents’ health records already subject to HIPAA).

(“CLIA” stands for the Clinical Laboratory Improvement Amendments of 1988, which established quality standards for certain laboratory testing.)

This carveout of lab results from patient-accessible records has long been a thorn in the side of the e-patient.  This month, Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

Challenges And Opportunities Of Health Care Social Media

I spoke on health care social media and regulatory compliance at the Health Care Compliance Association’s New England Regional Annual Conference last week.  As you may expect, the room was full of the folks who, generally speaking, are the folks who block social media sites on health care organization networks.  I sent a link to an online bio to one of the session organizers in advance, and even that site was blocked by his facility’s network.  Clearly, we have a long way to go in educating health care compliance professionals about the risks and benefits of using health care social media, and an appropriate approach to balancing these risks and benefits so as to establish an appropriate social media presence for each health care organization.

My talk was followed by a presentation by two federal prosecutors, one of whom reminded the audience that they may need to produce copies of all online postings in response to government document requests or subpoenas.  We may quibble about the scope of material that might be covered by such a production request, but the key takeaway from this comment should be Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

A FICO Score For Medication Compliance?

In Keeping Score on How You Take Your Medicine, Tara Parker-Pope of the New York Times, reports on a new initiative from the Fair Isaac Corporation (FICO) known previously for its credit score ratings.  FICO has developed a Medication Adherence Score, using publicly identifiable information (like employment status, age and gender) to determine a patient’s score, which it says “can predict which patients are at highest risk for skipping or incorrectly using prescription medications.”

Parker-Pope reports, “By the end of the year, an estimated two million to three million patients will have been given a FICO medication adherence score and a total of 10 million patients are expected to be scored during the next 12 months…FICO officials say insurance companies and other health care groups will use the score to identify those patients who could benefit the most from follow-up phone calls, letters and e-mails to encourage proper use of medication.”

The FICO medication adherence score has not received a universally warm reception: e-Patient Dave and Society for Participatory Medicine member Alexandra Albin point out that the score only accounts for whether prescriptions are purchased, not whether the pills have actually been taken.

In a related effort, Geisinger Health Systems and CVS Caremark are conducting a study to assess whether enhanced doctor-pharmacist communication can help with medication adherence.  Shefali S. Kukarni reports in Tracking Down Patients Who Skip Their Drugs that, “The 18-month investigation will track a prescription from the moment it is submitted electronically to the pharmacy until it reaches the patient. If the patient does not pick up the prescription a ‘red flag’ or some form of notification will be sent to the doctor.”

But as Jessie Gruman recently blogged, there is no magic pill to cure poor medication adherence.   Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Why Don’t More People Use Health Apps For iPhones And Droids?

Jessie GrumanI have been musing about why, despite our fascination with gadgets and timesaving devices, so few of us use the apps and tools that have been developed to help us take care of ourselves.

The range of options is staggering – my iPhone coughed up 52 applications for medication reminders just now – but most of us don’t make use of the (often free) high-tech help available to us.  There are hundreds of websites and portals to help us monitor our diets, physical activity and blood sugar, talk to our doctors by e-mail and understand our test results.  Apps can help us watch for drug interactions, unravel our test results, adjust our hearing aids and track our symptoms.  Devices can monitor whether our mom is moving around her house this morning or continuously monitor our vital signs.

Interesting ideas.  Modest pickup.

DSCF6172In an essay published in the May issue of the American Journal of Preventive Medicine supplement “Cyberinfrastructure for Consumer Health,” I make some observations about why this may be so, Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »