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Notes From The Connected Health Symposium 2010

I [recently] attended the Connected Health Symposium in Boston. I enjoyed many of the sessions (sometimes wished I could have attended two simultaneously, though the livetweeting — #chs10 — helped on that front), and as usual enjoyed the hallway and exhibit floor conversations too. As is often the case at conferences these days, I had the opportunity to meet several online connections in real life for the first time. 

(I will not attempt to give a comprehensive report of the symposium here. Please see the livetweeting archive and other reports to get a sense of the rest of the event.)

This year’s exhibit floor included a diverse mix of distance health tools. Most striking from my perspective was the fact that most of these tools do one of two things: Enable patient-clinician videoconferencing, or upload data from in-home monitoring devices. The best of the second category also trigger alerts resulting in emails or PHR/EHR alerts to clinicians if vital signs are out of whack, or phone calls to consumers or their caregivers if, for example, meds aren’t taken on time (one company had a pill bottle with a transmitter in the cap that signals when it’s opened; another had a Pyxis-like auto-dispenser, that looked like you’d need an engineer — or a teenager — to program it). One tool — Intel’s — seemed to combine most of these functions, and more, into one platform, but it’s barely in beta, with only about 1,000 units out in the real world.

The speakers this year seemed to return again and again to several major themes: (1) Is any particular connected health solution scalable? (2) Who will pay for connected health, or mobile health (mHealth)? and (3) Does it work? Read more »

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

The Government’s Involvement In New Primary Care Models

Government healthcare reform efforts are picking up the pace to roll out new reimbursement and practice models for primary care.

Medicare is giving out $10 billion for pilot projects encouraging new models of primary care, including the patient-centered medical home. New Jersey just passed legislation to explore the patient-centered medical home. Now, Massachusetts, the early adopter of mandatory health insurance, is now ambitiously planning how to take on the fee-for-service reimbursement system and moving toward accountable care organizations. Under discussion are the scope of power for state regulators, what rules will apply to accountable care organizations, and how to get rid of the existing fee-for-service system.

Blogger and pediatrician Jay Parkinson, MD, MPH, comments about the “bureaucrats in Washington” that, “they’ve decided for doctors that we’ll get paid for strictly office visits and procedures when, in fact, being a good doctor is much, much more about good communication and solid relationships than the maximum volume of patients you can see in a given day.”

Now, it’s those same bureaucrats who are changing the system, trying to find a model that will accomplish just those goals. (CMS Web site, NJ Today, Boston Globe, KevinMD)

*This blog post was originally published at ACP Internist*

Primary Care: Has It Been “Oversold?”

Citing a new study by the Dartmouth Atlas, the Wall Street Journal’s health blog provocatively asks: “Has the notion of ‘access’ to primary care been oversold?”

The Dartmouth researchers found “that there is no simple relationship between the supply of physicians and access to primary care.” That is, they found that having a greater supply of primary care physicians in a community doesn’t mean that the community necessarily has better access to primary care. Some areas of the country with fewer primary care physicians per population do better on access than other areas with more primary care physicians.

The researchers also report that the numbers of family physicians is more positively associated with better access than the numbers of internists, although they call the association “not strong.” Although both general internists and family physicians are counted as primary care clinicians, “in [regions] with a higher supply of family physicians, beneficiaries were more likely to have at least one annual primary care visit. In [regions] with a higher supply of general internists, fewer beneficiaries had a primary care visit on average.” Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Is Your Physician Patient-Centered? Five Ways To Tell

Hint: Being Designated As A Patient-Centered Medical Home Is Not One

We hear a lot about patient-centered care these days. In particular, a growing number of physicians across the country are now referring to their practices as a “Patient-Centered Medical Home.”

But how can you tell if your physician’s practice really is patient-centered, no matter what he or she may call themself? More importantly, why should you care? What is patient-centered care, you ask?

It’s quality care delivered in a manner where you feel that your provider:

  • Knows who you are personally as well as clinically.
  • Understands, respects and honors (where practicable) your previous health experiences, beliefs and preferences.
  • Facilitates and supports your health choices and behavior barring a serious conflict of beliefs or principles.

Since each of us possess a different set of experiences, beliefs and preferences, patient -entered care by definition is tailored to individual patients. Read more »

*This blog post was originally published at Mind The Gap*

Primary Care Crisis: Why The Patient-Centered Medical Home Will Fail

Everyone understands the need for a robust primary care workforce in making healthcare more affordable and accessible while keeping those in our care healthy. With the aging of America and healthcare reform, even more Americans will need primary care doctors at precisely the same time doctors are leaving the specialty in droves and medical students shun the career choice.

As a practicing primary care doctor, I’ve watched with great interest the solutions for the primary care crisis. And I’ve been utterly disappointed.

Patients so far don’t like the patient-centered medical home (PCMH) as noted in Dr. Pauline Chen’s New York Times column. The changes recommended won’t inspire the next generation of doctors to become internists and family doctors. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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