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You Better Stay Healthy, or Else…

Posted on June 23, 2014 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at kylesamani.com.

As I read Jonathan Bush’s new book, Where Does It Hurt? the most salient problem that Bush discusses is that hospitals can’t effectively measure or attribute their costs. As a result, they can’t make good decisions since they don’t know how to attribute costs and revenues.

Although this has been widely known for sometime, the implications of this are particularly interesting. Since hospitals don’t know how much it costs to actually deliver care (especially multi-faceted, complicated care), their various revenue streams are effectively subsidizing their expenses in an almost random manner. Accounting for costs and attributing revenue is nearly impossible.

Bush notes that more focused care centers – such as standalone labs, imaging centers, and minute clinics – can afford to offer many of the same services as hospitals with equal or greater quality at a lower cost. They can achieve this because they have dramatically less operational overhead than hospitals and have staff performing the same core basic functions repetitively. Indeed, practice makes perfect.

There are hundreds of companies all over the country building healthcare practices based on this very premise: labs, imaging, procedures, home health agencies, ASCs, birthing centers, cath labs, urgent care, retail clinics, and more. Focused-centers are slowly eating away at hospitals by providing better services at lower costs.

Today, hospitals make enormous profits by dramatically marking up routine procedures and services. But that won’t continue forever. As the ACA pushes patients towards high-deductible plans so that patients act more cost consciously, they will seek the more affordable alternatives. Patients will not agree to pay a $300 ER copay and $2000 MRI when the urgent care center down the street offers a $99 copay and $400 MRI. As patients make better decisions, hospitals will lose some of their easiest, most profitable revenues: extremely marked up lab tests, images, procedures, etc.

What will hospitals be left to do when their easiest, most profitable revenue vanishes? They will shift focus to what they do best: performing miracles. Hospitals will compete for high-end services such as-complex surgeries and intensive care. However, because routine services subsidize the hospital’s overhead, they currently offer surgeries and intensive care at a “discount.” When hospitals can no longer subsidize their complex care with routine care, hospitals will raise prices for the highest acuity services that can’t be performed elsewhere. If you thought acute sickcare was unaffordable, think again. The cost of complex care is going to grow dramatically in the coming years.

We Need Technology to Scale Healthcare

Posted on June 2, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was recently talking with one of my healthcare IT friends about the future of technology in healthcare. As we were talking, they made this really interesting observation:

“We Need Technology to Scale Healthcare”

I don’t think I need to go into too much detail with readers of this blog about the possible shortage of doctors that could happen. In fact, Kyle Samani covered some of this shortage in his post, “The Nurse Will See You Now.” In that post he talks about the limited number of residency slots that are available. Not to mention the lengthy path to becoming a doctor. I read an astute observation recently that the only reason we don’t have a real crisis in general medicine is because there’s a limited number of residency slots for the other specialties. When a med student can’t get into their desired specialty, then they fall back into general medicine. The idea of general medicine being a “fall back” profession doesn’t bode well for us, but that’s a topic for another day.

Consider the supply and demand constraints that Kyle talks about, we’re going to have a growing problem where the demand for healthcare outstrips the supply of doctors. Kyle covered the move towards nurse care, but I think there’s also an important case to be made for how technology can help to scale healthcare as well. As one example, Telemedicine has the potential to make our healthcare visits much more efficient. Properly implemented technology can do that across a wide variety of healthcare. Plus, technology has the potential to reduce unneeded office visits as well.

What I find even more intriguing is that right now we look at a visit to the doctor as a last resort for our healthcare. How many of us go to the doctor in order to remain healthy? Almost no one. If we really want to scale health care to the point that we’re providing health care and not just sick care, then that will require a scale that healthcare has never seen. I personally call this movement “Treating Healthy Patients” and I think this movement will be data driven with technology at its core.

Lest those reading at home get confused. I don’t think most of the healthcare technologies out there today work on scaling healthcare. Most of the healthcare IT solutions out there today are about optimizing the status quo. That’s very different than what will be required to scale health care. I’m excited to see these later technologies come to fruition.

Barcodes, Integrating Bedside TVs, EHR, and Nurse Messaging Into Pain Management Workflow

Posted on February 7, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I look across the healthcare IT landscape, I believe we’re just at the beginning of a real integrated solutions that leverage everything that technology can offer. However, I see it starting to happen. A good example of this was this case study I found on “Automated Workflow for Pain Management.”

The case study goes into the details of the time savings and other benefits of proper pain management in the hospital. However, I was really intrigued by their integration of bedside TVs together with barcodes, EHR software, and nurse messaging (sadly they used a pager, but that could have easily been replaced with secure messaging). What a beautiful integration and workflow across so many different technologies from different companies and this is just the start.

One major challenge to these workflows is making these external applications work with the EHR software. Hopefully things like the blog post I wrote yesterday will help solve that problem. Case studies like the one above illustrate really well the value of outside software applications being able to integrate with EHR software.

What I also loved about the above solution is that it doesn’t cause any more work for the hospital staff. In fact, in many ways it can save them time. The nurse can have much higher quality data about who needs them and when.

This implementation is also a preview of what Kyle Samani talked about in his post “Unlocking the Power of Data Science in Healthcare.” While Kyle wrote about it from the perspective of patients and getting them the right information in the right context, the same applies to healthcare providers. The case study above is an example of this shift. No doubt there will be some resistance to these technologies in healthcare, but once they get refined we’ll wonder how we lived without them.

Innovation at SXSW V2V

Posted on August 12, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This week I have the opportunity to attend the first extension of SXSW interactive outside of Austin. The event is called SXSW V2V and is happening in Las Vegas (yes, I have an obvious Vegas bias). Last night was the opening event and I was amazed at the depth of the interaction that occurred at the opening event. As I compare it to similar opening events at HIMSS it’s hard to even compare. At the HIMSS event it’s a struggle to engage people at the event. I usually do, because that’s who I am, but I was amazed how many people were willing and interested in engaging at SXSW V2V.

In one evening I had a chance to interact with a broad spectrum of people across the tech startup ecosystem. It was fascinating to see what various entrepreneurs are doing in 3D rendering, travel, bitcoin, and many other areas. I even enjoyed some time with Kyle Samani from Pristine. Kyle had his Google Glasses on and basically was able to start a conversation with anyone in the hall. I guess Google Glasses are a good investment if for nothing other than meeting new people at conferences.

I’m sure that many wonder what value I’ll get out of attending a tech event like SXSW V2V (Although, I do have a blog about Vegas Startup companies). No doubt there are very few people at the event working in healthcare specifically. Besides Kyle I also ran into my congressman who was an MD in a past life. So I did have a conversation with him about meaningful use (that post later). However, the lack of healthcare knowledge is exactly why I enjoy attending an event like this. There’s real value in getting outside of our healthcare box and seeing how we can apply technology or experiences from other industries to healthcare.

Take for example bitcoin. I expect that many in healthcare will wonder how a virtual currency will matter to healthcare. The obvious use is when people want to start paying your clinic in bitcoin. The less obvious application is using the processing power that “mines bitcoin” to solve some of medicine’s hardest problems. There are a lot of major healthcare problems that need a whole lot of computing power. The human genome was just the start. Bitcoin could be one way to access computing power well beyond the most powerful super computers in the world.

This is just a simple example of the power of learning things beyond the healthcare industry. I’m excited to see what other things I’ll learn over the next few days of the conference. Not that I don’t enjoy deep discussions about meaningful use and EHR certification. I love those too, but those deep discussions are often informed by learning about industries and technologies that aren’t in healthcare.