Kim Bellard

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Could Pokémon Go Help Fix Healthcare and Lead to Usable EHRs?

However promising gamification in health care may be, it is the AR that may well hold the most promise for health care.  Google was not wrong to pursue Google Glass, just premature. Pokémon Go may be signaling that we're now finally ready for AR, and that it will be consumers as well as professionals who can benefit from it. The potential uses in health care are virtually endless, but here are a few examples...Ever feel like your doctor spends too much time staring at your chart or a screen? Instead of looking there for information about you, how much better would it be if he/she was looking at you, with AR notations for key information about you?...

Crowdfunding for Healthcare

Elizabeth Rosenthal's searing article about medical billing, adapted from her forthcoming book An American Illness, is well worth a read.  Its topic of sophisticated medical billing/upcoding -- done by organizations ostensibly acting in the best interests of patients and often under the guise of a non-profit status -- is also worthy of a discussion itself.  This is not that discussion. What jumped out to me (and to many others, on Twitter and elsewhere) was the following indictment: "In other countries, when patients recover from a terrifying brain bleed — or, for that matter, when they battle cancer, or heal from a serious accident, or face down any other life-threatening health condition — they are allowed to spend their days focusing on getting better"...

Diagnosing the Problem with Direct-to-Consumer Pharmaceutical Ads

Quick: turn on the TV (no, streaming doesn't count!). You won't have to wait too long before an ad for some prescription drug comes on. Watch long enough and pretty soon you'll suspect that you have a variety of conditions that you may have never realized before and need to do something about immediately. Fortunately for you, of course, the pharmaceutical industry has solutions for you. It's all there in those ads. Whether we really understand them or not is another question. Direct-to-consumer (DTC) ads for prescription drugs are booming. After a brief respite during the most recent recession, they're back up, with spending estimated at some $5.2b in 2015 (amazingly, the DTC ads are less than 20% of pharma's overall marketing budget, with the majority of that going to face-to-face "educational" efforts with physicians)...

DIY Health to the Rescue

Experts often compare how slowly the health care system is "reforming" to how hard it is to turn a battleship.  They're so big that they can't turn on a dime (much less on $3 trillion!), and there is as much risk in trying to oversteer as in not turning at all.  Things are changing, we're assured, but it will take time to get on the desired new course. Maybe.  But maybe it is time to jump off the obsolete battleship onto something more nimble. Some call it Do-It-Yourself Health (there are both .org and .com sites devoted to the topic, among others).  PwC declared it to be one of the top ten trends of 2015.  Dave Chase believes that "DIY health reform is now leading the way for the highest performing reform" -- not Medicare, health insurers, not even employers...

Do Unto Robots As You...

We're going to have robots in our healthcare system (Global Market Insights forecasts assistive healthcare robots could be a $1.2b market by 2024), in our workplaces, and in our homes. Some of them will be unobtrusive, some we'll interact with frequently, and some we'll become close to. How to treat them is something we're going to have to figure out. Written by Alex Williams, Do You Take This Robot...focuses on people actually falling in love with (or at least preferring to be involved with) robots. Sex toys, even sex robots, have been around, but this takes it to a new level. The term for it is "digisexual." As Professor Neil McArthur, who studies such things, explained to Discover last year...

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Do We Really Need More Doctors? How About Trying to Have Healthier Folks?

Health care needs a better business model. HHS reports that U.S. health care spending will surpass $10,000 per person this year, will grow almost 6% annually for the foreseeable future, and will consume over 20% of GDP by 2025.  About half of our spending goes for labor costs, with health care employment remaining one of the "bright spots" in our economy.  Indeed, health care jobs continued to soar even when the economy tanked in our most recent recession. Despite that steady growth, we continue to talk about a physician shortage, especially for primary care.  Medical school enrollment is at new highs, yet it is not projected to dent the demand...

Does Healthcare Need More Programmers? Or, More MacGyvers?

Health care is full of black boxes.  As much as we think we've learned about the human body over the last hundred years, we're still constantly reminded about how little we actually understand its working (e.g., the microbiome). As much time and money we spend training physicians, much of how they diagnose and design treatments for patients remain a mystery.  And does anyone know why we always have to fill out so many damn forms? The many organizations working on applying AI to health care are trying to figure out some of these black boxes, although their solutions may come at the price of new black boxes.  I hope, though, that we don't just turn things over to AI.  We still need people to figure out the problems.

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Drones and the Future of Disaster Response

Four continental states and one U.S. territory took a beating this fall as one natural disaster after another rocked communities in Northern California and along the Gulf Coast, spreading disaster relief resources and personnel thin as federal, state, and local governments scrabbled to address the crises. Wildfires in California's wine country claimed at least 42 lives, 8,400 structures, and 245,000 acres of land in October. Hurricanes Harvey and Irma pummeled Louisiana, Texas, and Florida only to be followed by Hurricane Maria, which slammed Puerto Rico on September 20 and left much of the U.S. territory without communications systems, electricity, clean water, or functioning hospitals....

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Elon, Do We Have a Disaster for You!

One of the most interesting twists resulting from Hurricane Maria striking Puerto Rico was Elon Musk's offer that Tesla could help Puerto Rico solve its energy crisis, with a long-term, 21st century fix. After all, its electrical grid was devastated, with almost all the power wiped out. It didn't help that even prior to this disaster its system was antiquated and badly in need of repairs. It is telling that we don't have similar offers to rebuild the Puerto Rico's health care system, which is similarly devastated. Or, for that matter, our system, which is its own kind of disaster. Mr. Musk was asked on Twitter if Tesla could help Puerto Rico using solar and battery power, and he responded in the affirmative, saying it had done so on smaller islands but faced no scalablity issues...

Et Tu, Oscar? Are You Reinventing Health Insurance? Or, Just Repackaging an Old Plan?

I've previously expressed my concern that Oscar and some of its fellow health insurance start-ups might be more about repackaging than reinventing.  I'm more concerned than ever after Bloomberg reported that Oscar is adopting a new network strategy: moving to "tight, exclusive networks with hospitals."  Oscar CEO Mario Schlosser said: "The bet we made in going deep with a couple of health systems, I love what we’re doing there. We’ve got a very good blueprint now to go into new markets."

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Fewer Moonshots, More Walks

In a provocative op-ed piece, Jarle Breivik, a professor of medicine at the University of Oslo, takes aim at the National Cancer Moonshot Initiative announced earlier this year by President Obama.  Nice try, he concedes -- but the reality is: "We’re a lot better at fighting cancer. We just can’t cure it." Is this stereotypical Norwegian pessimism or just some badly needed Scandinavian bluntness? Dr. Breivik points out that cancer is fundamentally a disease of aging, and none of us is getting any younger.  All our efforts to improve lifespan end up putting us at risk of living long enough that we'll get some form of cancer...

First, We Tear Down All the Hospitals

The problem is that hospitals are big and getting bigger, going from building to buildings to campuses.  They are expensive and getting more expensive.  At some point, we have to ask: is this really how we want to spend our healthcare dollar? Some hospitals are figuring other ways to spend their -- I mean, "our" -- money on our health.  Take Nationwide Children's Hospital.  Located in a somewhat blighted neighborhood of Columbus (OH), its Healthy Neighborhoods Healthy Families (HNHF) program "treats the neighborhood as the patient," as their summary in Pediatrics put it. The hospital is leading a partnership that has built 58 affordable housing units, renovated 71 homes, given out 158 home improvement projects, and helped spur a 58 unit housing/office development.  They've also hired 800 local residents and instituted a jobs training program.

From Data Silos to Black Holes...the Story of America's Healthcare System?

The scary thing about black holes is that their gravity inexorably drags in everything within its reach. Unless you are very far away or have sufficient escape velocity, you will get pulled in, and, once you are sucked in, you are never getting out. We call it our "healthcare" system, but usually what we mean is medical care. It treats illnesses, it puts us under the care of medical professionals, it turns us into patients. A doctor's visit begats prescriptions, and perhaps some testing. Testing leads to procedures. Procedures lead to hospital stays. Hospital stays lead to....you get the idea. What we might once have thought of as "health" -- or never thought about at all -- becomes "health care," a.k.a. medical care. And once you transform from a person, whose health belongs to you, to a patient, your health is never quite your own again. You've been sucked into the medical care black hole.

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Getting Health IT on the Blockchain Bandwagon

Face it: health care IT infrastructure is a mess.  After spending tens of billions of dollars to "incent" providers to move to EHRs, they're using them but are not very happy with them.  In a world in which health IT systems should help improve patient care, they're seen more as a burden than as an asset.  We now have millions of electronic records that are still way too siloed, and all too often incomplete.  Worse yet, when those records aren't being hacked, they are being held captive by ransomware. Enter blockchain.

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Good Ideas From Unexpected Places: Thinking Creatively for Healthcare Innovation

How about this: in Harvard Business Review, two leaders at Johns Hopkins suggested that hospitals could learn something about buying equipment from -- drum roll, please -- the airline industry. You don't often find many people defending airlines these days, much less holding them up as good examples of anything (except, perhaps, about what not to do, what with overbooking, cramped leg space, plenty of add-on fees, and, of course, dragging paying passengers off planes).  That their recommendations make sense probably says more, though, about how poorly health care often does things than how well airlines do...