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Health Management Technology News
  April 30, 2014
In this issue:

 Health Management Technology’s Resource Guide sign-up

 Big Data becoming a mined-over matter

 Moody's predicts further wave of healthcare deals

 What healthcare really needs is a full-meal deal

 Big Data technologies and advancements in healthcare

 Healthcare reform post-deadline

 IBM looks to Watson to grow federal healthcare market sales

 Healthcare, androids and choice

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Big Data becoming a mined-over matter

In this era of Big Data or “metadata,” security is a lot like a flu shot. When you peel back the layers of marketing hype and media frenzy, you learn that the annual flu shot really covers only about half the strains floating around and being transmitted. It’s akin to a weather forecaster’s perceived accuracy rate.

Similarly, Big Data security efforts seemingly don’t prevent all of the threats, thefts and intrusions, according to a New York Times editorial in late January. So much for erecting those sturdy firewalls.

But is that good enough?

Should the healthcare industry resign itself to the idea that Big Data’s not-so-impenetrable HIPAA-fortified electronic fortress merely reinforces a wary confidence and conscience until a swarthy hacker violates its faith and trust in the “system”?

Healthcare experts admittedly stop short of labeling the Big Data concept the panacea or silver bullet to solve the industry’s considerable challenges – even as the information collected can be analyzed and used to foster burgeoning population health initiatives, one of the latest strategic catch-phrases making the clinical and trade show circuit.

Yet underneath the zeal surrounding population health, on-again-off-again ICD-10 conversion measures and the reams of data amassed on their way to becoming “useful information,” more healthcare organizations fret about privacy, protected access and security amid equipment thefts, hackings and illegal, if not accidental, exposure to data. Nothing can send the promise of healthcare reform spiraling into the abyss of doubt and uncertainty faster than data breaches, causing faith and trust in the system to collapse as quickly as the firewalls seemingly erected to prevent them.

Well-publicized IT breaches plaguing the retail market seem to be infecting healthcare providers, too, as the media reveal more outbreaks. And this is happening concurrently as healthcare organizations rely on Big Data analytics as a fix for short-term and long-term problems exposed under reform initiatives.

So what can and should healthcare organizations do to address – and quell, if possible – these breaches and fears? Health Management Technology contacted a group of IT experts to explore insightful and actionable strategies and tactics that make sense.

Read the full cover story from HMT here  

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Moody's predicts further wave of healthcare deals

The deal-making frenzy sweeping through the healthcare industry should continue apace in 2014, as companies look to stock up new drug pipelines, bolster existing businesses and diversify into new areas, Moody's Investors Service said on Tuesday.

Deals totaling more than $153 billion have been struck in the sector so far this year, the highest year-to-date level since Thomson Reuters began tracking such data.

Credit ratings agency Moody's said acquisition activity should remain high as makers of branded drugs look to buy companies with complementary or high-potential pipelines, while generic drug makers seek to build scale and diversify.

A complimentary trend is divestment, as drug makers shake up their portfolios to weed out or beef up businesses that lack critical mass, Moody's said.

This was the driving factor behind a series of transactions announced by Novartis for instance. The Swiss drug maker agreed to trade more than $20 billion worth of assets with GlaxoSmithKline Plc, with Novartis aiming to boost its cancer business while GSK sought to bolster its position in vaccines.

Read the full article from The Economic Times here  

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What healthcare really needs is a full-meal deal

On a daily basis, millions of Americans go into restaurants of all types and order package deals on food.

“Do you want fries with that?” has become so common, it’s a cliché.

But it’s also a poignant symbol of how business works throughout our society—if you bundle multiple items together into a package, you get a deal. It’s true in fast food, grocery stores, cable-Internet-telephone services, and innumerable other things.

But not in health care. If McDonald's charged its customers like the U.S. health care system does, not only would it make them pay separately for a hamburger, fries and drink, it would bill a different price for the meat, lettuce, pickle, mayo, ketchup, bun, wrapper, cup, soda and ice.

In fact, this piecemeal method of charging for services is so ingrained in the health care system that health insurers and third-party administrators that handle employer health benefits are, in many cases, incapable of processing package deals for their clients.

And doing bundled payments with the federal Medicare program was essentially illegal—until just recently.

“Federal statutes have historically outlawed the level of collaboration necessary to establish an effective bundled payment program. However, recent guidance from the Office of the Inspector General and waivers from [the Centers for Medicare & Medicaid Services] have cracked the door slightly ajar. It is still a complex web of legal requirements,” wrote Gene Ford, a spokesman for Indiana University Health, in an email about IU Health’s plans to launch a bundled price for knee and hip replacement surgeries this year.

Read the full article from here  

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Big Data technologies and advancements in healthcare

In August of 1854 there was a severe cholera outbreak in the Soho district of London. Within a month, several hundred people perished. Unable to ascertain the cause physician, John Snow, decided to plot all the mortality stats on a map. Once completed, it became easy to identify the cause. Looking at the visualization below, one can see the strongest concentration of Cholera outbreaks occurred right by a water pump on Broad Street. Thanks to Snow’s visualization, the government could quickly pinpoint the cause and take necessary action. They moved to shut down the pump, which shortly thereafter put an end to the epidemic.

Healthcare again seems to be an industry poised for data-driven innovation—offering the possibilities to improve trial safety, disease surveillance, prescribed treatments, patient outcomes and even potentially lead to the cure for cancer.

However, healthcare providers are having a hard time exploiting the Big Dataopportunity. In order to better understand both the opportunity and the challenge,EMC EMC -0.55% commissioned a study by MeriTalk, who surveyed 150 executives (IT and line of business) within Federal agencies focused on healthcare and healthcare research, to determine how Big Data can help them. This blog covers some of the results of that survey.

Read the full article from Forbes here  

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Healthcare reform post-deadline

We’ve passed the deadline for signing up for the Affordable Care Act, but how has it effected those in our area.

White House officials say more than seven million people are registered for health insurance through the online marketplace.

Hospitals like Hancock County Health Systems in Britt are getting ready.

Vance Jackson is an administrator at the hospital and says they’ve already seen more patients as Medicaid coverage expands.

“The state now allows us to do a program called “preemptive eligibility” where patients come into our E.R or into our clinic and we can screen them for coverage through expanded Medicaid,” said Jackson.

Affordable Care continues to be debated, as many feel the cost is not worth the benefit.

While there are short-term options for insurance, some are still opting not to buy it and instead pay the fines. In some cases that fine is one percent of their household income and some say, that cost may be cheaper than actually buying insurance.

It’s a gamble some say isn’t worth the risk.

“If you don’t get sick, if you don’t have any healthcare costs, the gamble is going to pay off. If unfortunately you do have something happen, maybe an accident or an illness or anything else the risk is not going to pay off for you,” said Steve Kammeyer, Director of Insurance Services with Iowa Farm Bureau.

Jackson says the focus should be long-term as hospitals around the country are also thinking ahead and to preventive care.

“There is no deductible related to preventive care. That’s where the government creates the incentive for us to offer more of those services,” said Jackson.

Read the full article from here  

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IBM looks to Watson to grow federal healthcare market sales

In January, IBM  chief executive Ginni Rometty pledged $1 billion to build out its Watson advanced artificial intelligence (AI) system from a $100 million business to a $10 billion unit in four years.

For IBM to grow its Watson business by 100 times in that short a time is no small order. In March, IBM challenged developers to build new Watson-related applications and said it plans to build an associated network of third-party cloud-focused AI partners. Late in 2013, IBM said it wanted to build a Watson app store along the lines of what Google, Apple and others have done with mobile apps, a clarion call to which 1,500 entities of one sort or another have responded.

But IBM figures the $13.9 trillion federal healthcare market is prime territory for its AI technology, as it just named a new chief medical information officer for its U.S. Federal practice and added new Watson Big Data solutions for advanced clinical care.

Dr. Keith Salzman, a 20-year veteran of the health IT industry, is IBM’s new chief medical information officer for its federal government business. Giovanna Patterson, IBM Federal Healthcare Practice vice president, runs the program, heading a network of some 300 federal healthcare consultants, medical doctors and healthcare professionals.

Read the full article from The VAR Guy here  

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Healthcare, androids and choice

As election season begins in earnest, conventional wisdom and the greenbacks emanating from the Koch brothers tell us that the Affordable Care Act will be central to the 2014 midterms. The Obama administration’s high-profile announcement of enrollment figures made clear that Democratic defense of the legislation—when it appears—will depend on out-spinning the GOP, replacing the Republican line that the health law has resulted in lost coverage and lost choice with a narrative about better, expanded coverage. Most Americans will likely react by muting the TV and retreating to whatever ideological corner feels most comfortable.

Before Americans throw up their hands, however, they might want to evaluate some of the assumptions underlying the Republican take on health reform, particularly its emphasis on choice. As in other features of GOP rhetoric, voters will find that what makes for a visceral ad does not necessarily gel with good policy.

Take the spot that the Koch-backed group Americans For Prosperity has begun running against vulnerable Democrats like Senator Kay Hagan of North Carolina. In all the ad’s iterations, the same actress declares that she detests political ads, but that “healthcare isn’t about politics…it’s about people.” She then accuses the ACA of causing millions of people to lose “their health insurance” and to lose access to “their own doctors,” and asserts that Americans are now “paying more, and getting less.”

A number of elements of the ad are noteworthy. For one, after the actress mentions “people,” the viewer expects her to say, “But, as an android, I can’t know what people want.” (Perhaps the Obama administration should enlist the androids of Janelle Monae’s artistic world as a corrective in its own ads.) More to the point, the spot progresses steadily from well-spun but accurate claims that the ACA’s minimum coverage requirements resulted in cancelled plans and changes in provider networks to the essentially untrue assertion that Americans are getting less bang for their buck in healthcare.

Some of this rhetoric about choice, then, is grounded in the facts. Because the ACA sets a number of basic services that all plans must cover, it led insurers to cancel plans that covered very little. People who could not get replacement plans with the same provider network, then, may have lost their preferred doctor. But the bit about “paying more for less” does not reflect reality; even those with higher premiums benefit from minimum coverage requirements, and with the law’s subsidies and prohibitions on discrimination based on health status, many Americans will pay less.

Read the full blog post at The Harvard Crimson here  

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