Archive for September, 2008

Quoted in the New York Times : Many Seek Second Opinions From Health Sites and Online Communities – NYTimes.com

September 30th, 2008 | Popularity: 19%
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Many Seek Second Opinions From Health Sites and Online Communities – NYTimes.com

All right, maybe this is the very first media I have done as an employee of The Permanente Federation rather than the recent television piece on NewsChannel 8. This interview actually occurred during the first week of my new employment, and was mostly based on my previous work with the California Healthcare Foundation.

I think John Schwartz has done a nice job inquiring about the phenomena of “Health 2.0″ and writing about what it means for patients. See what you think.

Public Comment – CCHIT Certification Commission for Healthcare Information Technology

September 29th, 2008 | Popularity: 20%
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Welcome to the very first public comment period for Personal Health Records draft criteria for certification:

Public Comment – CCHIT Certification Commission for Healthcare Information Technology

There is an introductory document that accompanies the PHR criteria that I encourage all commenters to read.

In getting to this point, I was trying to remember why I applied to be a part of this first workgroup, because I was initially skeptical about its utility. That changed when I saw the Advisory Task Force recommendations, and when I reflected on my first year of service, in the Foundations Workgroup.

The great thing about serving on this group for me was listening to a diversity of experience and role in health care and personal health records. I learned that personal health records can be more than a supplement to the patient-physician relationship – they can support health in a variety of situations. I wrote about their value in emergency situations previously, which is something I really didn’t envision in my previous work.

I also learned that some of the dreams we have had for personal health records, that they could integrate information from multiple sources, and be controllable and manageable by patients could come true. This would require that we decide what the most important building blocks are, and create an environment where experts across organizations could share best practices and create a 3-5 year vision for products, rather than a 6 month – 1 year vision, which sometimes happens within individual organizations. I think this is what CCHIT is supporting in its leadership.

The public comment period is intended to get us there, because the criteria are still draft. See what you think and thanks for your comments about the criteria (on the CCHIT Website, please).

How Business Pays for its View of Human Nature

September 29th, 2008 | Popularity: 17%
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As I just got done finished reading the column in Businessweek with the title of this post, I received the following link from Hilary Worthen, MD, about the value of good customer service:

Writing – Cooking – Life » Blog Archive » I Heart Zappos

These ideas must be on the minds of a lot of people these days, as Jack and Suzy Welch also wrote about it in their column “The Importance of Being Sticky.”

The best companies understand that a relationship of trust and engagement pays off handsomely, and this includes empowering staff closest to customers with abilities to correct errors and manage inconveniences.

Think about the analogies we use in health care without even thinking about it….

I recently had the experience of an editor doing a really great job improving an article I am writing for a peer-reviewed publication. One of the suggested edits, though, started with the sentence, “Armed with information, the doctor can….” They gladly accepted my re-edit and commentary that we are not war with our patients, we are at peace with them.

What is our view of human nature within the health care system and should we change it?

Halo Telepresence (Videoconferencing)

September 29th, 2008 | Popularity: 16%
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HP Halo: Listen to what people are saying about Halo

This seems very interesting in a Results-Only Work Environment – a lifelike telepresence (also known as videoconferencing) system, Halo, made by HP. I used to think that these were not useful, but I had read about Halo before after trying video meetings, which were useful, when the setup was easy.

See what you think.

Video: Bringing the world to your table |HP

…and Businessweek just wrote another article about this (telepresence) last week, as well.

BYOC: Company gives workers unusual laptop leeway – Yahoo! News

September 29th, 2008 | Popularity: 11%
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Electronic prescribing of controlled substances – National Governors Association STATE ALLIANCE FOR e-HEALTH

September 29th, 2008 | Popularity: 19%
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National Governors Association STATE ALLIANCE FOR e-HEALTH -

It seems that the people discussing this rule are hesitant to give their true opinions on how they feel about it.  Isn’t this a great opportunity to involve patients in the discussion to share their need for adequate pain control, and the community’s need for protected prescribing without diversion?  Here’s John Halamka’s discussion of this ruling, and the linked video provides more clues. Maybe, with patient involvement, a workable solution could be developed that allows these substances to be dispensed safely using electronic systems.

The State Alliance members will continue their discussions from their May 2008 meeting on ways that state policymakers can help facilitate electronic prescribing. A representative from DEA will present the proposed rule issued in June to allow electronic prescribing of controlled substances. A CMS representative will share information on current and future activities to support electronic prescribing in Medicare. The Alliance will provide NGA staff guidance on how the organization should implement the statement adopted in May by the State Alliance.
•Tony Trenkle, Director, Center for Medicare and Medicaid Services Office of E-Health Standards and Services
•Mark Caverly, Chief, Liaison and Policy Section, Drug Enforcement Administration Office of Diversion Control (Invited)

The High Concentration of U.S. Health Care Expenditures

September 29th, 2008 | Popularity: 19%
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Photo Friday: One Year DCversary! (I heart DC)

September 26th, 2008 | Popularity: 17%
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DC Heart Flags Tomorrow is my one year anniversary of arrival to Washington, DC, from the “other” Washington’s City of Seattle.

It occurred to me that I could pick any 24 hours’ worth of events to describe why I heart DC, so I’ll just use the last 24 hours, which started off with me meeting Josh Seidman, President of the Center for Information Therapy, for a walking meeting in Dupont Circle, which was joined spontaneously by Susannah Fox, from the Pew Research Center and e-patients.net. We walked Susannah to her workplace, passing both Hello Cupcake, where we talked about the arrival of the cupcake wars in Washington, walking past the offices of Bisnow.com, where I reminded myself to introduce Curtis Raye from Medical Bisnow to both Josh and Susannah in his profile of local health influencers. Later on, I received a tweet from Jen McCabe-Gorman who met Curtis at the Disruptive Women in Healthcare meeting, and the reciprocal tweet from Curtis (you could just see their twitterstreams coming together) that he met Jen. And so the epicenter of health care transformation becomes a little more epicentric.

This is happening in place with the most walkable areas per capita in the United States and with incredible diversity of cultures and thought. The only thing the District is currently missing for me are an Apple Store. And a Cheesecake Factory. (Both are three metro stops away in Virginia, though).

Place matters. We all deserve to find the best one for ourselves. Who’s yours?


Susannah Fox and Josh Seidman

In Front of the Counter with the Innovation Learning Network

September 25th, 2008 | Popularity: 24%
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One of the (many) groups I am excited to participate with in my new role is the Innovation Learning Network , which “brings together the most innovative healthcare organizations in the country to share the joys and pains of innovation.” Kaiser Permanente is a member, of course, as are many other leading edge American health organizations.

In learning about the Network, I spoke with Scott Heisler, RN, MBA, who works with the Kaiser Permanente Innovation Consultancy. He walked me through the innovation approach used by the consultancy (which by coincidence I read and blogged about right here), and then presented a concept that really interested me – the “in front of the counter / behind the counter” sensation that we sometimes have in health care.

I did a little looking on line and found this on McDonald’s Corporate Responsibility blog:

I couldn’t help but think about the challenges that all of our businesses have – regardless of our industry or size of operations – making the connection with our customers on the environmental improvements we have, and continue, to make. So much of our innovation happens “behind the counter”, so it’s almost invisible to our customers if we don’t proactively communicate it.

I think this is a useful way to think about things, especially when we talk about involving patients. Are we thinking about the front-counter experience in everything we do? Are there times when we inappropriately ask people who are part of the care team (nurses, allied health, other physicians, patients and their families) to be in front of the counter when they should be assisting behind the counter? Or should we change the front of the counter experience in such a way that people don’t have to come behind the counter to support a safe, affordable, high quality care experience?

I then remembered what’s happening with New York City restaurants, and one in particular: when more information was provided to consumers, Le Pain Quotidien learned that this was better business for all of their stores (including Washington, DC) and adjusted things behind the counter to support it.

It’s interesting to think about how working from the front of the counter can create improvement…..Either way, I’m looking forward to following the work of the ILN, and encourage readers from innovative organizations to think about doing the same.

Talking about Interoperability on Washington’s Newschannel 8

September 24th, 2008 | Popularity: 23%
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Newschannel 8 - 1

Today was my very first work with the media as an employee of The Permanente Federation. I was asked to support a national conversation led yesterday by colleagues George Peredy, MD, Simon Cohn, MD, and Andy Wiesenthal, MD, regarding interoperability of health records between Kaiser Permanente and Veterans Affairs, which I was happy to do.

The interview took place at Washington’s NewsChannel 8, in Rosslyn, VA, which also hosts ABC News 7 and the Politico organizations. As I was walked around the facility, they said I could snap photos of the newsroom, so I did, and they are posted here.

As part of preparing for the day, I reviewed some of the numbers around Kaiser Permanente member adoption of personal health records, and I have to say, it is really at a scale that is unfathomable (or at least at a scale I will need to begin fathoming) – almost 2.5 million members with access to secure features on kp.org, 300,000 new users in the 2nd quarter of 2008, 1.5 million secure e-mails sent to doctors, 4.2 million test results viewed online. There are on average 122,000 visits to kp.org every day – in the space of a week this may be as many outpatients as some health systems manage in a year.

I didn’t get asked information at that level of detail – it just reminded me that there’s a lot to represent in this organization. I did get asked about the demonstration that happened yesterday, by anchor Dave Lucas and he seemed very impressed at the potential breakthrough this could be for Wounded Warriors and patients everywhere. It turned out that Dave has good experience here – he said after the interview that he’s been a medical reporter for 15 years and knows how patients see the value of being connected to their information at the right time. I think the work demonstrated yesterday is a great step forward, and that it’s great to have people in media who work with patients and know what they expect to see in their health care system. We all improve that way.

I’m not sure if I’ll get access to video to post here or not, but in the meantime, thanks to everyone at NewsChannel 8 for the warm welcome (even at the front desk, where I got great coaching to “smile, and it’ll be all right.”), and for the chance to have a seat in the world-famous Goss’ Garage while I was waiting!