Posts Tagged ‘Health care’

Bold Leadership in Healthcare

What’s happening at CVS Caremark is an emerging business case study in visionary leadership.

CVS made headlines for its decision to discontinue selling cigarettes, capturing the gratitude of many people, including the White House.
cvs logoThere was chatter among analysts that this move will trim $2 billion from the company’s revenue, a fact that only seemed to add to the feelings of goodwill among current and potential customers. The widespread response from consumers was, “This is a wonderful thing that CVS did. They didn’t have to do it. They’re doing it not in the best interest of the business, they’re just doing the right thing.”

From a PR perspective, it created a real sense of warm fuzzies towards CVS, increasing pressure on other chains like Walgreens and Rite Aid to follow suit. It has been assumed that management calculated that goodwill towards CVS would result in more customers and more foot traffic, and eventually these new customers will replace the lost revenue. (In fact, trimming $2 billion in revenue, while meaningful, likely will have a modest effect on the stock price. It reflects less than 2% of total revenue, and its contribution to net income is roughly $70 million. Given that the new policy won’t even take effect until October, it will have negligible impact on 2014 company performance.) Read Full Article Now »

GiveForward: Doing Well by Doing Good

Sometimes you come across a company that truly epitomizes the concept of “doing well by doing good,” and you realize that it’s not just an idealistic dream.

GiveForward is such a company. They are an online fundraising website that specializes in helping ordinary people raise money for a loved one with a medical need. GiveForward has developed an online platform that makes it easy for a friend or family member to create a personalized fundraising website and invite their friends and family to contribute. Their mantra is to “create unexpected joy.”

joySo far GiveForward has helped raise $62 million for medical expenses!

The company is the only online site that has fundraising coaches who provide advice and fundraising ideas for raising money online. The team has learned a lot about what it takes and even publishes their top fundraising tips and tricks.

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Email is the killer healthy app

E-mail is still the killer app.

But it will become the killer healthy app if Dr. David Kibbe has his way.

David Kibbe is a physician with an MBA and a history as an outspoken thought leader and change agent in healthcare. And he doesn’t like what he sees from the traditional enterprise approach to health information technology.

Kibbe has a vision for using technology to support patient care, and he helped to instill the four “guiding principles” of the Center for Health IT at the American Academy of Family Physicians.

According to the Center for Health IT, electronic health record (EHR) solutions must be:

  • Affordable (for small and medium-sized practices)
  • Compatible (with other vendor products)
  • Interoperable (across offices, hospitals, labs, etc.)
  • Allow for fair data stewardship (in which the physician and patient own the data)

When Kibbe looks across the health IT (HIT) landscape today, however, he sees numerous large systems integrators and complex EHR products vying to drink at the trough of federal stimulus money. There is very little interoperability between systems, and last year Kibbe in an open letter to President Obama stated, “If America’s physician practices suddenly rushed to install the systems of their choice, it would only dramatically intensify the Babel that already exists.”

A simple, user-friendly approach
What he does want to see is a simple, user-friendly approach for doctors that will achieve the benefits of ubiquitous health information.

Is there an alternative that is cost-effective, easy to use and quick to market?

What about e-mail?

“Simplicity can be the lever that makes more collaborative things happen,” says Kibbe, and he has identified three important trends that could make a large difference in whether HIT is broadly adopted in our lifetime.

There are thousands of “non-users” practicing medicine today, physicians who find the current offerings intimidating and expensive. An industry organization called Clinical Groupware Collaborative was formed to identify affordable ways to bring HIT to this group of physicians. Their philosophy is that “there is value if there is a simple way for physicians to communicate, akin to e-mail.”

Secondly, there is a federal office called the National Health Information Network, or NHIN, that was formed in 2004 to devise secure and private standards for communicating health data. It quickly became a large, cumbersome network controlled by large enterprises with an evolutionary plan that could easily be another decade in the making. Fortunately, cooler heads have prevailed, and a new office, NHIN Direct, has developed a lightweight health information protocol using secure e-mail that provides an easy “on ramp” for providers and organizations.

Finally, there is an important provision in ACA (formerly known as PPACA, the healthcare reform law), called “meaningful use.” It provides a financial carrot to physicians over the next few years to participate in data exchange to support coordinated patient care, engagement of patients and submission of quality data. And if physicians don’t participate, then in a few more years there will be a financial stick in the form of penalties. Both doctors and HIT vendors are evaluating solutions based on whether they can quickly achieve meaningful use.

It’s like open source software
These three trends are converging around a vision of HIT that is more like the open source software movement than the old private email networks. Given the low-cost entry point of this model, it is more likely to see adoption by thousands of small physician offices.

Still, buying a system and actually using it are two different things, and to qualify as meaningful use, doctors must begin using the technology to do real clinical stuff, like contact patients, write prescriptions electronically, handle patient referrals and submit outcomes data. According to Kibbe, “adoption needs to approach 50% for a breakout scenario to become realistic.”

Not like Prodigy and AOL
Kibbe sees interesting parallels with the point in the early evolution of the internet when Prodigy and AOL were the only ways for consumers to communicate online. These were large, slow and ultimately non-scalable private networks that charged by the e-mail. They served their purpose for a few years but it wasn’t long before more nimble technologies and open networks replaced these behemoths. Soon e-mail was no longer just a novel alternative to the post office. It was a fast, cheap and safe way to communicate. It became the killer app.

If the stars align as David Kibbe and his comrades suggest they are, e-mail, a “back to the future” style of innovation may ultimately undermine the large EHR solutions. Once again it will be a killer app, but this time a healthy one.

What do you think about what David Kibbe is trying to do?

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Keeping America Well

The internet has revolutionized retail. In travel, consumers use self-service websites to search for destinations, compare offers and purchase a vacation. Amazon has replaced the knowledgeable bookstore owner with breadth and convenience. Yes there are trade-offs, but most consumers are willing to exchange professional expertise for price and convenience on non-critical decisions.

But not so with healthcare. Yes, consumers go online when they have a health question, but sometimes they leave more confused than before. Convenience yes, but expertise? Questionable.

If you ask Dr. Roy Schoenberg, CEO of American Well Systems, he’ll tell you why. “In the consumer’s mind, healthcare is not online portals or health risk assessment tools. Healthcare is about talking to a doctor.” We receive healthcare when we explain our symptoms to a physician, he or she diagnoses the problem and then recommends a remedy.

There’s still a convenience problem, however. Often at the point of need, many of us can’t get in to see our doctor. It may be 2:00 a.m. and your child is crying, or you are experiencing pain and your doctor’s calendar is booked for the next three weeks.

But what if you could log on to the internet (convenience) and talk live with a physician (expertise)? And what if that physician could call up your health records as the connection was being made? And finally, what if this “doctor’s visit” was covered by your health insurance (price)?

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Learning How to Nudge

Still exercisingIn a recent article in the Wall Street Journal, a Ms. Ruthanne Lowe from San Jose, CA reported that three years after her participation in a Stanford University study on behavioral change, she is still exercising. The study showed that even just a gentle nudge can have a positive effect on motivation.

The issue of how to support patients with chronic illnesses is back on the healthcare front page. Studies show that even if a patient sees a doctor, gets diagnosed, and receives a care plan, whether a drug or a regimen like diet and exercise, up to 50% of those patients will elect not to follow through. The prescription won’t be filled or the healthy life choices won’t be followed. So even if 32 million new consumers in our new health care world get access to a physician, half of them likely won’t take their meds as prescribed.

That’s a big problem.

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Opening salvo

Obama signing healthcare reform billRegardless of your point of view on healthcare reform or the much-discussed legislation, the Patient Protection and Affordable Care Act (PPACA) is now the law of the land in the United States. Our friends in every corner of the healthcare sector are scrambling to understand what reform means for them and how to take advantage of new opportunities or mitigate new risks to their business.

Any time there is a significant change in the business rules of engagement, whether it’s tax policy or new regulations, company executives look for loopholes or workarounds to maintain their competitive positioning and avoid additional burdens. With the passing of the healthcare reform bill, general counsels and consultants everywhere are looking for ways to avoid complying with the new law.

Don’t do it.

The right response is not to dodge, hide or obfuscate. At this point, with healthcare costs projected to rise to nearly 25 percent of GDP in the next 15 years if we don’t intervene, we need to rethink the industry. Like the industrial revolution that laid the first transcontinental railroad, created the auto industry and put a man on the moon, we need a healthcare revolution. We need an innovation revolution.

The only way out of the healthcare morass in the United States is through innovation.

An incremental approach to insurance reform and consumer access will have a commensurate incremental effect on the cost curve. What we need is to dramatically rethink how to prevent and diagnose disease, how to treat chronic illness and how to compensate physicians. We need to apply technology in new ways to bring targeted therapies to market quicker and to package the latest in behavioral change theory to create wellness programs that become part of our pop culture. And we need to understand how even little nudges and informal social support can have a big impact.

Every sector in healthcare has a role to play, from providers and health insurers, medical device and pharma companies, large employers and government agencies, teaching hospitals and research institutes to entrepreneurs and venture capital firms.

This blog, The Difference Makers, is my personal journey to find those entrepreneurs who are applying innovation to health and healthcare. I want to see if big problems require big solutions or small solutions. I’m curious about whether the diffusion of innovation in healthcare follows the same curve as it does in technology, and whether the market economy, the public economy or a combination does a better job of meeting the needs of the patient. And I’m curious about what it means to put the means of health production in the hands of the consumer.

Innovation + Entrepreneurialism meets a Big Challenge. It’s worked before. Let’s see what happens this time.

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