Hospitals are increasingly relying on electronic tracking systems to keep tabs on equipment and lab specimens, and even to monitor the location of patients and staff. But the heightened surveillance is raising some safety and privacy concerns. The growing use of tracking technology has privacy experts warning that hospitals must take steps to protect any personal data from being inadvertently released, and requiring healthcare workers to wear tags raises questions about putting staffers under undue surveillance.
Express Scripts Inc. said a small number of its clients have received written threats to expose their personal information. The pharmacy-benefits management company said the threats are believed to be connected to a written extortion threat the company made public last week, which is being investigated by the Federal Bureau of Investigation. The letter included personal information of 75 members. Earlier this year, there was a spate of security lapses at hospitals, health insurers and the federal government, in which private information on hundreds of thousands of patients. The steady stream of privacy breaches threatens to undermine the healthcare industry's effort to adopt electronic medical records. A major barrier to healthcare digitization has been anxiety about preserving the security of such sensitive data.
A lot of ailing Americans enter phrases like "flu symptoms" into Google and other search engines before they call their doctors. That simple act has given rise to a new early warning system for fast-spreading flu outbreaks, called Google Flu Trends. Tests of the new Web tool from Google.org, the company's philanthropic unit, suggest that it may be able to detect regional outbreaks of the flu a week to 10 days before they are reported by the Centers for Disease Control and Prevention. The CDC reports are slower because they rely on data collected and compiled from thousands of healthcare providers, labs, and other sources. Some public health experts say the Google data could help accelerate the response of doctors, hospitals, and public health officials to a nasty flu season, reducing the spread of the disease and, potentially, saving lives.
The English city of Manchester is hoping to fight fat with a reward system that works like a retail loyalty card. Residents will be rewarded for keeping their feet on the treadmill and their fridge stocked with healthy food. Starting next fall, Manchester residents will be able to swipe their rewards cards and earn points every time they buy fruits and vegetables, use a community swimming pool, attend a medical screening, or work out with a personal trainer. Points can be redeemed for athletic equipment, donations to school athletic departments, and personal training sessions with local athletes.
Everyone is feeling the pinch of the ailing economy. Meanwhile, the government is tightening reimbursement regulations and seemingly trying to take back money it has already paid hospitals. What can hospitals do to weather this financial storm? The obvious answer is anything that will improve the bottom line. +
Well, it's finally over. The 21-month long saga that culminated one week ago today in Barack Obama being chosen as America's next president. Even as his supporters were celebrating victory, President-elect Obama wasted no time getting down to business. By Friday, he had already chosen several key members of his transition team, including two technology advisers: Washington technology policy expert Julius Genachowski, an Internet business veteran and former executive of Barry Diller's IAC/InterActiveCorp.; and Sonal Shah, a tech executive from Google's philanthropy division, Google.org.
Obama's choice of two technology experts to help guide his transition into office has bolstered his previous assertion that technology will play a major role in the new administration. And Obama has made it clear that health information technology will play a central role in his plan to overhaul the health system.
His plan is to invest $10 billion a year over the next five years to promote broad adoption of standards-based electronic health information systems, including electronic health records. He also plans to phase in requirements for full implementation of health IT and appoint the nation's first chief technology officer (rumor has it that appointment could be made as early as tomorrow) to coordinate the government's technology infrastructure, work on issues of transparency, and "employ technology and innovation to solve our nation's most pressing problems," according to Obama's Web site.
The big question now is how and when Obama will put such an ambitious (and expensive) plan into action, especially given the country's economic problems.
Blair Childs, senior vice president of public affairs at Premier Inc., says that he expects to see a number of healthcare initiatives enacted as soon as 2009, including a realignment of the payment system to incentivize quality and efficiency.
"Despite everything else that is happening, I still expect to see a huge amount of focus on healthcare in 2009. There is also a lot that is going to be decided over the next month with the three Senate seats. If the Democrats get those three seats, or even two of them, they will certainly have an easier path toward getting a bill done," says Childs. Though Democrats made several gains in the 100-seat Senate, the fate of three seats remains to be determined.
We have seen some movement toward paying providers for adopting e-health initiatives. Beginning in January, CMS will implement an electronic prescribing incentive program for physicians, which will increase Medicare payments by 2% for doctors who use the technology. While that program is a step in the right direction, it will take many more like it to get providers to invest in expensive electronic systems, says Childs.
The primary goal of the Obama healthcare plan is to increase access to care and decrease healthcare costs. And while health information technology will play a central role in reaching both of those goals, it certainly won't be without some considerable obstacles, says Ned Moore, CEO at Portico Systems.
"If we cover all of the uninsured, that is going to mean there will be an additional 47 million people eligible for health insurance. You can imagine the impact that will have on the system infrastructure. Before that happens we need better, faster, more tech-enabled solutions in place," says Moore.
Though Moore emphasizes that there is not one solution to ensure the infrastructure can withstand such a massive influx of new members and new claims, health plans should begin looking now at what systems they have in place, and how much those systems can handle, he says. On the provider side, he says, CIOs may want to be asking themselves if there is some technology you can invest in to streamline operations, knowing you could have a surge of volume in the near future.
"We've just got to be pushing the idea that everything will be digital, everything will be electronic. Web-based systems are going to have a very integral role in what I believe will be an evolutionary process," says Moore.
I think that everyone can agree that when he takes office in January, Obama will have three main priorities: the economy, the war, and healthcare. What I've been hearing in the early days after the election is that we can expect a phased in approach to the changes he has planned. Most industry experts also believe that it will be technology that will play the biggest role in increasing access and decreasing costs. And finally, as Childs says, if healthcare information technology is going to live up to its potential in the coming years, the payment system is going to have to be revisited and revised to incentivize those investing in it.
Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at kmackenzie@healthleadersmedia.com.
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Intel Corporation has announced its Intel Health Guide, a care management tool designed for healthcare professionals who manage patients with chronic conditions. The Intel® Health Guide is a comprehensive personal health system that combines an in-home patient device as well as an online interface to allow clinicians to monitor patients in their homes and manage care remotely, according to an Intel release.
The melding of healthcare and wireless technology is creating new tools for providers. Driven by laboratory breakthroughs, falling prices of existing technologies, and interest from major companies such as Qualcomm, Intel, IBM, Microsoft, and AT&T, wireless healthcare is expected to grow to a nearly $2 billion industry in the next five years.
Are you a true believer or a skeptic that medical travel will have a significant impact on the U.S. healthcare industry? I've talked to people on both ends of the spectrum and the spaces in between. While some predict emerging global options are the health system's new revolution, others say the barriers between consumers and offshore providers are too difficult for most to overcome.
No matter where you stand on the issue, at this point I haven't heard or read a convincing argument that the opportunity for widespread medical travel is not at least possible. We have plenty of cases of consumers traveling to the other side of the globe to receive surgical procedures that 10 or 20 years ago would have required long and involved inpatient care.
Frequently proponents of globalization cite the high cost of healthcare in America relative to overseas providers as the incendiary factor for medical travel's explosive growth. In the next five to 10 years we'll know for sure, but we'll need to see if these four aspects of the industry evolve enough to support outbound medical travel.
Technology coordinates care
The issue is not whether the technology exists; it does. The know-how and equipment necessary to monitor patients in remote locations, for providers dispersed across the globe to exchange data and ideas, for patients to access and use their health information. We have or can develop all of that. The real questions are: Will enough providers adopt the technology to support distance medicine? And will enough consumers use EHRs in meaningful ways to make healthcare choices?
Employers stop sponsoring healthcare
We've been seeing this one coming for a while now, and a shaky global economy only gives employers another reason to get out of the business of sponsoring healthcare. A recent example is yesterday's headline in the New York Times that GM needs to drop retirees' health plans. Employers are saying they can't support skyrocketing healthcare costs and stay competitive against global competition. The high cost of care isn't likely to come down anytime soon, so we'll see more employers attempt to delicately remove themselves from providing the benefit. At the same time, employers have a vested interest in their employees' health and could coordinate DM and individual plans for employees.
Healthcare consumerism finally takes hold
If employers coach employees out of sponsored insurance and into individual products with high deductibles, the thinking goes that since they've got skin in the game we will end up with real healthcare consumers. These consumers will shop for healthcare procedures the way they shop for cars, homes, and vacations. They will use the Internet to gather and compare information on price and quality and make informed decisions. And if the comparison is a $40,000 knee replacement in the U.S. versus $9,000 at a JCI-accredited hospital in India (including airfare), the barriers for medical travel won't seem so great anymore.
U.S. providers mount a response
Now if all of the above fall into place as some analysts predict they will, the last area to consider is how U.S. providers might respond. If pre- and post-operative opportunities emerge, one response could be that American providers see that they cannot compete on value and find ways of joining with offshore hospitals to provide a continuum of care for patients that choose the medical travel option. Another possibility is that we see more cases like Hannaford Bros Co., in which the supermarket chain added a medical travel option and soon found U.S. providers willing to make counteroffers.
There are a lot of ifs in this week's forward-looking column. While I've stated before that I don't yet consider U.S. outbound medical travel a major trend, it is a development worth watching very closely. In the healthcare industry especially, time is fleeting and these changes could be confronting us even quicker than we thought. As I consider these factors, I find myself becoming a believer more and more.
In his blog, Harvard Medical School Chief Information Officer and Dean for Technology John Halamka offers predictions about what the first year of Barack Obama's presidency will hold for health information technology. One of Halamka's hopes is that the Obama team will offer incentives to implement EHRs early in the administration.
