HealthNex

BusinessWeek: The Family Doctor: A Remedy for Health-Care Costs?

How making primary-care physicians the center of America's health-care system could drive down costs

Interesting story in BW that includes some discussion around IBM's patient centered medical home model. Here's an excerpt:

This medical home may sound like the "gatekeeper" model of the 1990s, a managed-care creation that was all about holding down costs. But advocates say the new concept is designed to help patients, not insurers. It's more like doctoring 1950s-style, when a Marcus Welby figure handled all the family's medical needs. This time it's juiced up with digital technology.

It also represents a politically painless way to streamline a disorganized and wasteful system that chews up a crippling 18% of the U.S. gross domestic product. That burden is felt particularly by private industry, which covers 60% of the nation's insured. Since most businesses try to ferret out waste and disorganization in their own operations, the medical home is a concept they can embrace in good conscience.

One of the biggest advocates is IBM (IBM), which shelled out $1.3 billion last year on health benefits for its U.S. employees and retirees, equal to one month of the company's net income. Dr. Paul H. Grundy, 57, who holds the unusual title of director of health-care transformation for IBM, is a medical-home evangelist who led the company to start the Patient-Centered Primary Care Collaborative, a coalition of some 500 large employers, insurers, consumer groups, and doctors. Part of his goal, he says, is to show that "employers can drive the medical-home idea as buyers of care."

IBM Chief Health Officer Janet Marchibroda on Smarter Healthcare

Janet Marchibroda is the chief health care officer of IBM

"As President Obama and Congress take on what the president in his American Medical Association speech called the "ticking time bomb" of health care costs, they need to know that they can't succeed without harnessing the massive data generated by modern medicine. Getting the best information into the hands of doctors and patients, while protecting patient privacy, is not just a desire but an overriding need if we are to get a handle on spiraling costs and also improve care. "(read the rest @ There Can Be No Health Care Reform Without An Information Revolution - Forbes.com)

MY PWeR (Personal Wellness electronic Record) is an intelligent, comprehensive  system is equipped with 24 applications ranging from Electronic Medical Records to electronic prescriptions to transcription solutions. MY PWeR also assists with electronic billing, reporting and analytics, and many other practice management tools.

Earlier this year Quantum announced the launch of the PWeR healthcare information platform and selected IBM as a cornerstone of its information management, storage, security and privacy focus.

See more on the Smarter Planet: Healthcare channel on our Tumblr site.

Frontline Docu: Sick Around the World

I watch Frontline's Sick Around the World documentary last night and really recommend it to all as a sober examination of the healthcare issues that are such a high priority in America today.

Here's a preview below.  You can watch the whole program online.

What I found most insightful about T.R. Reid's reporting was the clear and practical way he looked at the pros and cons of the national health systems in the U.K., Japan, Germany and Switzerland.  Even more impressive was learning how Taiwan went about reinventing their healthcare system by drawing on the best elements of programs around the world.

I certainly hope we can follow such a practical process to turn around the fragmented U.S. healthcare situation, which the Harvard-trained architect of the Taiwan program noted is not a system, but rather a market. Finally, I know that the politics of healthcare is a hot-button issue, and that many Americans are very wary about the role of government in healthcare (even though we are already a quasi-nationalized system via the Veterans Administration and Medicare/Medicaid). 

What I liked most about this investigation is its positive and constructive tone: what can we learn from the rest of the world, and how can we be smart about the evolution that most Americans hunger for?

20 Simple At Your Desk Exercises For Web Workers

  Nurses participating in an e-learning course 
  Originally uploaded by computer_aid_international

This useful health tip comes to HealthNex courtesy of Amy Quinn at the Livesmarter blog.

My Virtual Fitness Epiphany: Expresso Fitness Cardio Bicycle

Let me start by saying while I prefer elliptical and treadmill trainers, I hate stationary bikes, spinning classes etc. I don't even much like riding a bike in the real world.

But I did find the Expresso virtual cycling experience compelling, and offer it as an example of where 3D technologies may play a bigger role in healthcare by turning gym exercising from a chore into a game.

Gyms and healthclubs already have many kinds of displays, including plain-old-television, integrated into workout equipment to distract or entertain  people will they burn some calories and raise their heart rates.  What was refreshing about the Expresso experience was the way in which I didn't just feel distracted, but more immersed in the activity, like I was actually riding a bike through a beautiful park at sunset.

In fact "Bliss Park" was one of dozens of scenarios that I could choose to ride through. I could really see how this "exergaming" approach might lend itself to other scenarios, like turning a stairmaster into a mountain climbing adventure or an elliptical machine into a cross-country ski mini-vacation.

I'm sure that some people's reaction to the idea of virtual worlds workouts will be: why not just  go ride a bike in a park, climb a mountain or run in the real world? To that understandable reaction I've got two thoughts. First, I prefer to run on a treadmill than actual streets or parks.

The treadmill really compels me to keep moving, and allows me to count the calories and heart rate, while actual running requires me to convince myself to keep picking them up and putting them down. Of course, its also about the value of something like the rush of mountain climbing or skiing, without the travel, time and expense of the realdeal. (Though I'll stipulate that there's nothing better, in my view, than a great day of realworld skiiing.)

Second, there seems to be something about simulated reality that tickles our brains. Just look at the breadth and depth of electronic, multiplayer games.  In fact, there is something about the game-like, playful nature of electronic experiences that may be the real secret sauce here.

I grew up playing all kinds of sports--ice hockey, baseball, football, basketball, skiing, tennis, windsurfing, rock climbing-- and like most kids the impetus was the fun of the game itself, not the exercise or health benefit that I might derive. As an adult I've been faced with the reality that working out is a necessary evil...the work you need to do to stay healthy for one's family and one's economic well-being.

In the final analysis, I'm hungry for anything that can turn exercising back into a game. Back into fun. And I that score, I think Expresso's virtual cycling experience (which can also become a kind of competitive, online multiplayer experience as well) feels to me like the shape of much bigger things to come.

Global Citizenship and Healthcare: Dr. Paul Grundy

I was delighted to come across Dr. Paul's podcast, part of the package on IBM's new corporate responsibility report: Global Citizenship.  I'm also excited to see how this new view of the kind of good that major global businesses can do in the world is taking root, and resonates with the Global Citizen's Portfolio program that I'm working on, with many other IBMers, including Kevin Thompson, who interviews Dr. Paul in this podcast.

Paul, IBM's director of healthcare technology and strategic initiatives, is also the kind of IBMers who exemplifies the way in which we can all contribute to making the world a better place.

Podcast: Dr. Paul Grundy

Run time: 18:27
File size: 16.9 MB.

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Read Transcript (PDF, 57KB

IBM 2007 Corporate Responsibility Report
We are surrounded today by vast new possibilities. To achieve them, we must come together in new ways, and assume new responsibilities.

• Corporate responsibility at IBM: a foreword by IBM’s chairman
• Table of contents
• Of individuals
• Among organizations
• Across society
• What is corporate responsibility in the 21st century?
• Key performance indicators

Getting Paid to Quit

In my previous post I briefly alluded to IBM's QuitNet program, which rewards employees for not smoking, as well as another that gives IBMers a rebate for being physically active.

By coincidence, the NY Times has a story today on this trend of corporations taking the initiative on such healthcare/wellness fronts. Check it out:

Seeking Savings, Employers Help Smokers Quit

Health 2.0 @ Stanford

Techcrunch has an interesting post today on BeWell@Stanford, "an online community that aims to promote healthy living among the school’s 30,000 students, faculty, and staff."

This notion that social networking can help support and promote wellness is a good example of how the so-called "people-powered Web" can be a part of the solution for a more innovative healthcare ecosystem that both improves the healthiness of broad populations, and in so doing may reduce costs.

This wellness front is something that I know IBM takes seriously.  In fact, the company actually provides small bonuses for IBMers who commit to a regular exercise regime, and another for those who quit smoking.

This notion of prevention as the best medicine is far from new, but the idea that a community could help support and sustain better health of individuals is part of what makes the world of social computing so interesting today.

Finally, I think there's an interesting parallel between the increasingly important role that wellness/prevention plays in healthcare and the idea that efficiency, waste reduction and conservation play on the energy front.

As the CEO of Duke Energy has noted in a Tom Friedman column "Go Green and Save Energy," becoming a society vastly more efficient is effectively like finding a new source of energy. What's more, energy savings is the cleanest new source of energy.  What he proposes is deep new financial incentives to energy producers to save energy, not just provide it.

Similarly, such efforts at wellness and prevention like Standford's new initiative are really about new mechanisms to give people the incentive and social support to be healthier, which while not very sexy on the face if it, may be one of the biggest avenues of societal innovation in healthcare at our disposal.

Blogposium is a Go: April 18-19

Jack Mason, IBM Strategic Communications, HealthNex Producer

The consensus from the health IT blogosphere is....let's do this thing! So mark April 18-19 on your calenders.

To reiterate: Blogposium will be a two-day, virtual collaboration among our circle of bloggers to show the world that together, we can do real and practical work. To make this cross-blog cooperative experiment a success, we'll keep the work and the objective relatively simple:

The Objective:  to help flesh out The Clinical Informatics Wiki started by Dean Sittig with a dozen or more new entries, so that this wikipedia-like resource will become more useful for all.

The Work:  In the next few weeks, each participating blogger will choose a topic related to healthcare IT  (I'll take on Biobanking, for example) research it, and prepare a first draft for an entry in the ClinfoWiki. Entries should include basic definitions, links to supporting material, etc.

April 18: Bloggers will post their first drafts on and all of us, as well as all our readers, will provide comments, suggests and edits on each other's work. Everyone should include links at the bottom of their draft to the preliminary drafts of fellow Blogposium participants, so that we will pass traffic and editorial eyeballs around.

April 19: Based on community input, bloggers will post their second draft, for ultimately inclusion in the wiki.

The beauty of this approach, we hope, is that each participant can draw on their particular interests or expertise, and contribute something of practical value with only a short commitment of time and effort. 

And if we can succeed with this fairly straightfoward effort, perhaps we can take on tougher assignments in the future, and demonstrate that a confederation of bloggers can be  a really useful engine, to paraphrase my 3-year-old's Thomas the Tank Engine obsession.

How to Participate:  Shahid Shah was kind enough to register people's previous interest in this collaboration. He's currently traveling. But in the expectation that he can create a similar registration page for people to declare their topics, that will be the plan.  Stay tuned.

How to Help:  First, spread the word to fellow bloggers who might have the kind of expertise to participate, as well as to the broader audience who can lend their collective intelligence to make our entries smarter and sharper.

Second, alert the media! This is by no means an exercise in self-promotion, but a public experiment to push the boundaries of what a ring of bloggers and readers can accomplish together. In this case, the greater the attention, the more productive this collaboration will be. For my own part, I will be working with my IBM colleagues to shine a light on this project.

Of course, if you have other thoughts on how to make this collaboration a success please add your comments hear or send them to me at [email protected]

This should be an exciting and fun little piece of work for all of us. And given the enthusiasm so many of you have shown towards the idea of working together toward some common good, I'm proud to be connected to all of you.

Blogposium Countdown: t-minus 20 days and counting.

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