One of the most important provisions in the health reform bill has little to do with expanding insurance coverage, and has gotten little attention this week. But employers will be able to offer greatly enhanced health promotion programs. There will be government grants to help cover the cost of these programs, and employees can receive up to 30% discounts on their health insurance for participation.  Research on the effectiveness of the programs will be increased, and if proven effective, insurance discounts may go to 50%!

Lots of credit has to go to the tireless promotion of such programs (no pun intended) by folks like Michael O’Donnell, editor of The American Journal of Health Promotion, and the work in the trenches developing these programs, like Ray Fabius and Ron Goetzel at Thomson Reuters.  Shout outs have to also go to companies like  Johnson & Johnson, Alcoa, Highmark in Pittsburgh, and Alcon (the contact lens company) who have been pioneers in changing the workplace culture to encourage healthy behaviors.

From a recruiter’s point of view, I am eager to see how many employers are going to embrace this opportunity to create a healthy, productive workforce; Because I know some rockstar program managers who are ready, willing and able to design world class health promotion.

This is a true win – win. Health Innovation, population health and wellness in action.

From where I sit, the elusive holy grail of care management has been to empower patients to make better (healthier) decisions.  We have seen Disease Management companies use nurse call centers, Web – based elearning and coaching companies, even incentive – based programs that use things like frequent flier miles to get members to fill out an HRA!

It seems like people are finally figuring out that the most trusted source of information for patients is still their physician.  Just like Marcus Welby. Some things never change.  The Medical Home Models all require that the hub be the physician – patient relationship, and care coordination be built around that hub.  One of the really interesting job postings we have is for a primary care clinical scholar at Baylor in Dallas.  BHCS has long been known for world class quality and outcomes, and now they are on the leading edge of care coordination along with evidence – based best practices in primary care.

If this were easy, it would already be done, right? But the perverse incentives of our fee for service reimbursement system do not encourage primary care practices to create the infrastructure to be the hub of a coordinated care management team……which leads me to my Health Innovation prediction for this year (or soon, anyway)  A cottage industry is going to develop around the reengineering of primary care practices that makes it easier to do coordinated, collaborative care.  Creating registries, reminders, contacting the right patients at the right time so that better healthcare decisions are made.

One company who is managing to to do good stuff like this DESPITE the fee for service system is Phytel.  Check out some of their case studies. www.phytel.com

Please contact us with more success stories in patient engagement and primary care transformation. I know you are out there…

I didn’t make it to HIMSS last week, but I did go to the Population Health/Medical Home conference in Philly. It was an incredible conference, with many presentations on innovative models that could help fix our broken healthcare system.  What was interesting was how little discussion there was around the likelihood of  passage of a health insurance reform bill.  No, people at this conference were more excited about what innovations are likely to result in quality, affordable care, and are not too engaged in the current Washington debate.  The medical home model, now expanded to include Accountable Care Organizations (ACOs) seem to have great appeal as a way to coordinate care, eliminate care gaps, and make transitions from one caregiver to the next member of the team more seamless.  I found a great presentation given recently by Debbie Peikes of Mathematica Policy Research on promising models. This is required reading:
http://www.mathematica-mpr.com/publications/PDFs/health/promising_models_peikes.pdf

I understand the frustration we all have with the progress of healthcare reform.  But from some of the recent articles I’ve been reading, you would think that all of the healthplans, all of the disease management companies and even the doctors are just evil, money hungry monsters!  Check these two links out; One from the SF Chronicle, the other from Business Week! 

http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2010/02/21/MNC91C0NVJ.DTL

http://www.businessweek.com/magazine/content/10_07/b4166046292556.htm

Now, I know that there are Healthcare IT companies, Integrated Delivery Systems, and even GOVERNMENT run programs that are doing good work.  For example, there are positive ROI’s to be had in chronic disease management programs.  Check out the results that Pharos Innovations got in their Iowa Medicaid pilot and with the Henry Ford Health System in reducing CHF readmissions:
www.pharosinnovations.com

Please pass on more success stories, so it doesn’t seem like all doom and gloom out there!

To be successful today, healthcare organizations need to have the right information in the right place at the right time so that they can make better decisions and deliver better care.

Having the right technology is critical, but does not insure success. There are several other keys to success:

• Top–down buy in on the value of technology in healthcare delivery
• Willingness to commit the time, money and TALENT to the informatics strategy
• Giving clinicians and non–clinicians the right tools that allow them to use technology effectively to do their jobs better
• A clinical integration strategy; how many organizations have looked at this as an “IT implementation” which was doomed to failure from the start because the IT department and the clinical delivery teams did not communicate effectively?

We all know of organizations that have thrown money into what seems like a black hole, without much of a cohesive informatics strategy to show for it.

From our seats, we have seen the good, the bad and the ugly in informatics.

It’s time for Informatics v2.0…

We welcome ideas and input, and hope that our blog can be a place for the exchange of war stories good and bad, so everyone doesn’t have to repeat the same mistakes.  We’re going for meaningful use here!