HealthyComms

SHIFT Communications experts discuss all things healthcare and media.

The Three Things I Learned about the Affordable Care Act from “The Daily Show” with Jon Stewart

Jon Stewart has mocked the Affordable Care Act (ruthlessly). He’s held cringe-worthy interviews with Nancy Pelosi and Kathleen Sebelius, and hasn’t hesitated in dubbing the legislation the “Affordable Horror Story.” Over the past few months, however, he’s gleaned some positive repercussions from of the legislation – which we would be wise to keep in mind.

1. The Affordable Care Act met its Seven million enrollment goal by deadline (by making the hard sell).

America’s Got Coverage

Though the Affordable Care Act met its target enrollment number of 7 million, the Obama Administration claims it didn’t give the legislation a “hard sell.” Jon Stewart reminds us that the first impression many Americans had of Obamacare was a failing Healthcare.gov and other health insurance exchanges. The Obama administration, as a result, resorted to promoting the legislation in a positive light to everyday citizens (particularly younger demographics) in every way possible – including The Ellen DeGeneres Show, the Rachael Ray Show, The Tonight Show, Between Two Ferns – as well as some “unique” YouTube videos. Hard sell or not, the enrollment figure was reached, although skepticism and doubt still exists surrounding the true number… 7.1 million enrollees seems a bit lucky, doesn’t it?

2. The Affordable Care Act provides everyone access to the “best healthcare system in the world” (not just those who can afford it).

Third World Health Care – Knoxville, Tennessee Edition

Anti-Obamacare advocates have claimed from the get-go that the Affordable Care Act is the worst thing to ever happen to the U.S. healthcare system – it will bankrupt our country, provide us with fewer healthcare options, and ultimately, push the U.S. into third-world healthcare conditions. Jon Stewart (with the help of Aasif Mandvi) puts things in perspective – was our healthcare system really perfect? Not particularly – WHO rated the U.S. at #37 on the list of the world’s top healthcare systems, and in reality, people are already living in poverty, with high rates of cancer and heart disease. Of course, the U.S. provides plenty of options – for those who can afford it. But there have always been citizens who “fall through the cracks” – those who are desperate for health insurance or medication but who cannot afford the help they need. There’s always room for improvement; maybe some drastic reform is exactly what we all needed.

3. The Affordable Care Act is meant to help our economy (despite apocalyptic predictions)

A report released by the Congressional Budget Office claimed that because of the Affordable Care Act as many as two million people could leave their jobs, as a job is not necessary to receive comprehensive health benefits under the ACA. Some news outlets proceeded to mistakenly report that the Obamacare legislation is cutting two million jobs. Ultimately, the CBO concluded that the ACA doesn’t necessarily result in employers cutting jobs – just newly-empowered workers choosing a different path. There is no compelling evidence, as a result of the CBO report, that part-time employment has increased because of the ACA, and the ultimate goal of the legislation is actually to reduce the national deficit (not add trillions of dollars to it, as was reported).

There have been plenty of mishaps in the rollout of the Affordable Care Act. But by watching “The Daily Show” with Jon Stewart, I think we can all agree that we need to pay attention to the facts and take a closer look at what we’re hearing on the news.

The One Where the 24th Line Item in a Bill on Medicare Shook an Entire Industry

icd10 takeover

Above you see the front page of Healthcare IT News from April 2nd, one day after President Obama signed a very-non-April-Fools’-Day joke of a bill on “Protecting Medicare”. The bill, coming at the urging of several physician groups, touches on a great number of aspects related to billing, payment, reimbursement and cost management of Medicare.

Yet it is one single section – the 24th listed provision in the bill if you’re keeping score at home – that seems to have hit the nerve the most among the Health IT industry. I grabbed the screenshot above because during a news scan for something else, but was struck how one of the industry’s most important pubs have dedicated this much ink space to the issue. It shouldn’t be a surpirse to see this reaction – even just one month ago, CMS’s Marilyn Tavenner claimed no delay was anticipated. So the industry was a little rightfully peeved that all that “we’re really doing this” rhetoric got balled into a completely different political battle.

ICD-10 was truly a sneaky inclusion in a bill that had more to do with political points around Medicare, payment and some segments of the house. There isn’t even a real example as to why the bill’s sponsor added ICD-10 into his list of provisions – he hasn’t responded to constituents and the provision was never actually addressed during the (swift) debate of the bill. The word bundling was used more than once as to how it even happened in the first place.

Healthcare IT has had a rough few months in the policy realm. First it unfairly got held responsible for whatever happened technology-wise at HealthCare.gov’s launch (which was an IT problem for something related to health, but not healthcare IT). Now it is caught in unrelated battles of point scoring for sides coming to grips with the fact that the battle over the ACA is pretty much over and done.

Buried as item 24 in a bundle, the true concern has more to do with an industry that has to hurry-up-and-wait-or-just-wait-longer. There are benefits to ICD-10, and yes, many of them sound unenticing and complex to your non-healthcare person (population health! epidemic tracking! more detailed bills and codes! specificity around the side of the body!). Yet that story isn’t really going to hit the ears of congressmen or the general public or really even physicians. This is a story of output and analysis, really, and certainly not the most exciting.

The  real problem that has us freaking out about Section 212 isn’t the data, it’s the implementation of trying to figure out how we want our electronic health records to tell us stuff. This is the fifth delay by my count (we’re a long ways from October 2011 at this point), and we’re getting concordant voices asking for other coding systems (SNOMED-CT) or even just saying the hell with it, ICD-11 is set for international implementation in 2017.

The real issue is the the guy who is trying to buy a patient record and document system and just wants to know what language it needs to speak. Uncle Owen knew he could need a droid that spoke Bocce, and C-3PO was the right fit – but as long as CIOs don’t know what they need, we may never get to the end of the Empire.

Wearables: The Future of Health Tech?

1984

Photo Credit: 1984 Film Virgin Productions

When George Orwell published 1984 in 1949, the world was still recovering from the tragedies of WWII. The possibility of Big Brother was still fresh in their minds with the recent rise in power of Adolf Hitler. The vast population would have done anything to protect their personal privacy from an all seeing and all tracking eye.

Now let’s jump ahead 65 years. We are in a technologically advanced society and the issue of privacy is constantly on our mind. We want to maintain our personal space while we push for more openness and connectedness through social media. We are truly at an interesting crossroads. I think the one area that these clashing trends really hit home are with the rise of wearables in the health tech space.

Wearables, otherwise known as wearable computers, have become the latest trend over the past year. People wear these small bracelets or watches that collect a wide array of data to help improve your life. This data is stored on the cloud and can help you improve whatever your desire is. The FitBit flex measures the amount of steps that you take and monitors your sleep. The Lumo Lift, debuting this summer, will also measure steps but will also give you a nice buzz when your posture isn’t perfect. Even Google is jumping into the mix with Google Glass and Android Wear. Heck, if we are willing to trust our health data with Google, we really have come to love the perceived benefits of these devices.

What these wearables give us is insight into ourselves that we cannot gain just from our own inner searching. I depend on my wearable to tell me how many steps I take and if I am meeting my personal goals. If I tried to manually count every step, I wouldn’t be able to do anything else with my day. Our personal health has become such a central focus of our existence that we need to outsource the data collection and analysis to these devices. We behave exactly like organizations that use data analytics companies to give them insight into their populations. We are just doing this on a much smaller scale. (Speaking of scales, Fitbit now has the Aria, which will digitally synchronize your body fat and weight to your phone. Talk about a detailed data analysis of your health!)

We have moved past our fear of Big Brother and have welcomed these tech start-ups and giants to monitor our data to give us the slightest chance of living a healthier life. The only area where we seem to have a concern about privacy is when the government wants to view that “private” data that we willingly share with those we choose to. But that is another topic.

Does this mean we are headed into an Orwellian dystopia and we should burn our wearables before they evolve into the terminator? Nah! The data collected helps us become the people we strive to be, even if it is only a little nudge to get up and walk around the office a few extra times a day.

Bring on the wearables!

Happy St. Patty’s Day!

Today, Boston will probably be seeing a lot of F10.129 along with W22.02XD*. Happy St. Patrick’s Day to all!

ICD10_St Pattys

*F10.129 = hangover caused by too much alcohol consumption; W22.02XD = walked into lamppost.

Image courtesy of a RT from @JennDennard, original post by @NextGen.

Health Boom Ready to Bust at SXSW?

The Austin technology, film and music festival SXSW draws to a close this weekend in Austin, TX. The 10 day event that draws approximately 60,000 people has morphed in recent years, growing from a mainly music and film focused festival to being a flagship event for the technology industry with the three day “Interactive” programming.Image

A colleague who attended the festival this year told me that the presence of corporate giants was far more noticeable this year than in the past. He saw a Cottonelle relaxation station and Marlborough smoking lounge, to name a few. But another more positive trend that he mentioned – and that we’ve seen covered all over the news — was that SXSW seems to be less about new technologies and launching startups and more about exploring education and health than ever before.

Hugh Forrest, the director of SXSW Interactive said they had specifically highlighted several health related events this year and that while health had always had a presence at Interactive, this was the first year it had been featured so prominently.

But it’s not just being jammed down people’s throats, the presence of digital health seems to have grown by popular demand. The Wall Street Journal reported that Rock Health, the famed digital-health incubator, was expecting a few hundred attendees at their Sunday “boozy brunch” displaying new wearables, but in fact more than 9,000 people registered to attend.

Will SXSW become a must attend conference for the healthcare set? Or is it a digital health bubble filled with trendy cuffs and other wearables that will quickly lose their allure?

Bonnie Cha at Re/Code noted that current activity wristbands like the Nike Fuelband, Fitbit Force and Jawbone Up do a good job of inspiring short-term behavioral change, but they’re not effective for long term behavioral health changes. Many in the healthcare space have making this point for ages. Work my some of clients in the healthcare venture capital industry leads me to believe that wearables are in their infancy. The Jawbone Up will soon be as outdated and clunky as the brick-sized cell phone.

While some companies are heading in the right direction and rethinking the look and feel of these technologies to be more fashionable, their utility is still extremely limited when it comes to the bigger picture of healthcare.

Our friend Jane Sarasohn-Kahn participated in a SXSW panel which explored the issue of the digital health bubble and she blogged about the advice for entrepreneurs in the space coming out of that panel. One of the key takeaways was that people building new health companies need to really, truly understand the health care system. 

It will be interesting to see how this all plays out. But – no matter what the Healthycomms team will be down at SXSW in 2015 for sure.

No Surprises (from a Media Perspective) at HIMSS14

As a second year veteran with better shoes and more dedicated sleep hours, HIMSS14 had a much calmer, smoother tone for me. From a media perspective, that also seemed to be the case as well.

Last year, the CommonWell announcement took over the HIMSS13 press room and I found myself eagerly waiting for the same thing to happen.

And waiting…

By 5:00 p.m. on Wednesday, it was clear there were going to be no surprises that would consume the media and news cycles like last year. Of course that’s not to say there were no major announcements. Here are a couple that caught my eye:

  • CMS Administrator Marilyn Tavenner made it crystal clear that there would be absolutely no delays to the ICD-10 October 1 deadline. No shocker there but as Carl Natale of ICD-10 Watch notes, if end-to-end testing this summer reveals major issues, we may see some “creative deadlines.”
  • CommonWell didn’t make waves like last year but did garner some attention around the addition of CVS Caremark as an Alliance member and also received some press around their interoperability progress (good summary by Jennifer Bresnick at EHRIntelligence.com).
  • The hosting organization, HIMSS, pushed out a ton of great research as well that highlighted everything from workforce updates to the achievements (and barriers) that healthcare organizations have faced in implementing health IT and mobile health technologies. As usual, the Media Leadership Brunch was well attended with over 40 members of the press in attendance to hear the results of the 25th Annual HIMSS Leadership Survey.

So “big news” wasn’t the theme for this year but with a record-breaking attendance of more than 38,000 attendees and 1,233 exhibiting companies, HIMSS14 was still plenty exciting and the conference healthycomms team had a blast. It’ll be interesting to see what HIMSS15 brings as we’ll be well past the ominous ICD-10 deadline. Chicago, here we come!

 

Disclosure: Please note, HIMSS is a SHIFT client.

Growing Happiness: Social Good in your Corporate Culture

“It may sound too good to be true, but once you’ve seen the happiest people in your life who have nothing, you really start rethinking what the world, and society, tells us that we need to be happy.”

-Blake Mycoskie, TOMS

Happy

Happiness is a powerful thing. In essence, everything we do in our lives is to further our own happiness. We choose where we live, what we eat, our friends, and our activities around what makes us a happier person. We go to work every day to make money to support your happiness (and hopefully if you are like us SHIFT-ers, your job makes you happy, too). So it isn’t so far-fetched to understand that there is a rush of entrepreneurs that are looking to combine their daily grind with social good ventures.

Social Good is the latest “trend” in business. Mashable has evolved their social good awards into an annual summit. SXSW is filled with sessions that focus on social good and changing our environment. The one thing that I find ironic is that in the healthcare field, where health has a major impact on your happiness, has not caught up with the trend of social good.  So why aren’t we seeing this more in the healthcare industry?

Now don’t get me wrong. There are some great healthcare companies out there that are built around social good. Most of them are in the healthcare crowd-funding realm or patient geared social networks. The social good I am referring to is building “giving back” directly into your core values; build giving back into their daily lives and encourage, if not demand, that their employees do the same.

Looking beyond healthcare- a company like Patagonia, a clothing company for the silent sports, has built social good into their entire company. They have an environmental grant campaign to support organizations that protect Earth’s natural habitats. They also have The Common Threads Partnership where they work to reduce the environmental footprint. These initiatives exist to support the world and are in line with Patagonia’s mission- but they don’t directly add to the corporate bottom line.

Nature

Why do you need to consider organically grown social good into your corporate culture? It’s simple. Incorporating social good shows your employees, potential employees, clients, and the world that you care. If you care about something other than the bottom line, then you must also care about the people that work for you and with you. Your employees will be happy with you and their tasks. The big secret is- the happier and more dedicated employees you have, the better your bottom line will reflect.

So take this as a challenge. How can you build social good into your business for the sole purpose of making a difference? We all live in this world – so let’s make a change for the better!

From Quantified Self to Connected Self

A recent infographic from StartUp Health, 2013 Digital Health Funding Insights, illustrates the tremendous growth the digital health industry has experienced over just the last three years. This infographic shows where the money is flowing – including increasingly to household names like FitBit.  Building on this, the news coming out of this year’s Consumer Electronics Show (CES) surrounding wearable devices (“wearables”) drove home the fact that interest in the concept of the quantified self is becoming less fad and more fact of life.

Image courtesy of Medical Practice Insider

And, if you’re still questioning the role and forthcoming impact of wearables, you may want to consider the investment Apple is making in this space. Moreover, based on data from the U.S. Census Bureau and ABI Research, the number of wirelessly-networked body sensor devices that connect via Bluetooth to a smartphone or tablet manufactured is expected to exceed the U.S. population within the year. Take a minute to absorb that particular statistic.

Still, what will all these wearables add up to? The problem with these tracking devices is that the useful data they capture isn’t connected, so to speak. Meaning the number of steps taken or minutes slept are useful facts that we use to make ourselves feel better about our health and wellness, but they’re not connected to the clinical teams who can use such data to impact personal and even population-based health. So, while entertaining, these devices currently lack the ability to create a more significant impact.

Which leads me to a question we’ve been discussing here at SHIFT – what needs to change to get more people engaged in closely tracking their own health and wellness? It’s this initial groundswell of adoption that will drive the development of a system that connects the individual data points we each collect on a day-to-day basis, and turns them into insights that can impact our lives.

As a former owner of a FitBit, I lost interest in using the tool after just two months. While motivating in that it mentally pushed me to jog that extra half mile or take walks on my lunch break, it was by no means addictive and there was no real incentive to keep using it. Which leads me to another related question we’ve been pondering, in order to increase adoption of wearables and, in turn, gather more data on a personal and population-based level, do we need our health insurers or employers to reward or penalize us based on engagement in the personal tracking of our health and well-being? It’s clear we need an incentive of some sort to transition from the quantified self to the connected self – but what’s the right approach to making this behavioral change a reality?

At the end of the day, the move toward the quantified self isn’t the interesting part. It’s not the wearables, be it glasses or bracelets, that are intriguing. It’s the idea that connecting these wearables, and all the data they’re amassing, might serve a greater good and allow us to uncover truths that will help us live longer, happier lives.  With this is mind, I think we’ll find interest growing beyond wearables over the coming months with an increased focus being placed on enabling the connected self – much the same as we’ve seen with both the connected car and the connected home.

Gamifying Health IT For Patients and Physicians

The quest for a lot of health IT is putting into the context of what might make sense around other technology we need. For example, if we can log into just about any site these days with a Google or Facebook ID to leave a comment, why are using different terminals for EHRs so challenging and require multiple layers, learning and settings?

With that in mind, what about *other* aspects of consumer tech that haven’t fully crossed-over? One idea that came up quickly among our team here and now I’m trying to figure out the extension on is how gamification could play into Health IT. First, there are gamification components of the hottest-things-in-healthcare in wearables – whether personal or directly built in, one of the reasons to track is to compete against yourself or the system – and the fusion of wearables and HIT is happening or in the near future. Second, it has similarities to the technology that patients are most familiar. The check-in revolution is far from fresh but still fascinating – and if that can make technology more familiar to physicians because of their personal use of tech, then all for it.

I’m not saying we need to build in badges (“You’ve reached Dysplasia, Level 5! That’s 30 EHRs filed!”) to get physicians to help speed up the adoption and ease the pains of EHRs. To me, the opportunity is in relating to the consumer, providing a method that is understandable as their clinician types away in the corner of the exam room. Points aren’t awarded for completeness, but in relative nature to what a physician and consumer are able to understand together.

In concept and in actuality, it’s out there – but we’ve tried lots of other things to increase adoption, why not look to consumer tech?

2013 in review

The WordPress.com stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 3,600 times in 2013. If it were a cable car, it would take about 60 trips to carry that many people.

Click here to see the complete report.

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