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Major Healthcare Issues I Think IT Could Help Solve

Posted on November 16, 2012 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.

Yesterday and today I spent my time at the Accountable Care Expo in Las Vegas. It was a small intimate event, but those that were there were some really smart people who knew a lot about healthcare and about accountable care organizations. It was quite the education for me. Plus, as with most learning, as I learned more about ACOs I realized how much more I still don’t know.

During the conference I started to think about something I’d heard quoted quite a few times. At this conference they said, “3% of patients are consuming 60% of healthcare dollars.” I’ve heard a lot of different numbers on this. I remember hearing that 10% of patients have 80% of healthcare costs. Regardless of the exact numbers, I’ve heard this enough to believe that a small number of patients drive a abnormally large portion of the healthcare costs in this country.

When you think about this, it becomes quite clear that these “expensive patients” are likely those with chronic conditions. That’s the easy part. The harder part is that I’ve never seen anyone analyze the makeup of the 3-10% that are driving up healthcare costs. For example, what if 90% of those “expensive patients” are chronic patients over the age of 65. Solving this problem would be very different than if we found that 50% of expensive patients are diabetics under the age of 20.

How does this apply to health IT? First, health IT should be able to sort through all the big data in healthcare and answer the above questions. How is anyone going to solve the problems of these “expensive patients” if we don’t really know the makeup of why they’re so expensive?

Second, I believe that some health IT solutions can be implemented to help lower the costs of these chronic patients. I’ve seen a number of mHealth programs focused on diabetes that have done tremendous things to help diabetic patients live healthier lives. That’s a big win for the patients and healthcare. We need more big wins like this and I think IT can facilitate these benefits.

Since this post has taken a slight diversion away from my regular topics, I wanted to look at another thought I had today about healthcare. This tweet I sent today summarizes the idea:

All of the numbers I’ve seen indicate that hospitals are the most expensive part of healthcare today. Hospitals are just expensive to run. They have a lot of overhead. They work miracles regularly, but they come at a cost. While more could always be done, I feel safe saying that many hospitals have squeezed out as much cost savings they can out of the hospital. This means that in order to save money in healthcare we can’t strip more cost savings out of hospitals. Instead, we need to work to keep patients from going to the hospital.

There are a lot of ways to solve this problem (I heard of one payer putting instacare clinics next to ERs to save money), but the one I hear most common is the need for primary care doctors to have a more active role in the patient care. If they had a more active role once a patient is discharged from the hospital, then fewer patients would be readmitted to the hospital.

How then can we structure a program for primary care doctors to be paid to keep their patients from being readmitted to the hospital? That’s the million dollar question (literally). Everyone I know would happily pay a primary care doctor a half a million dollars in order to save millions of dollars in hospital bills. That extra money might also help us solve the primary care doctor shortage that I hear so many talk about.

I can’t say I have all the solutions here, and I don’t expect these things to change over night. Although, I think these will be important changes that will need to happen in healthcare to lower costs. Plus, I think IT will facilitate an important role in making these changes happen. Imagine something as simple as an HIE notifying a primary care doctor that their patient was admitted or discharged from the hospital. This would mean the doctor could go to work. Now we just need to find the right financial mechanism to be sure they act on that notification.

I’ll be chewing on these ideas this weekend. I look forward to hearing other people’s thoughts on these issues.

Healthy Food Guide Uses MyPlate.Gov Standards to Track Calories

Posted on I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

In case the other food diaries I’ve mentioned here on Smart Phone Healthcare haven’t been your style, be sure to check out Healthy Food Guide.

Healthy Food Guide is based on the dietary recommendations that can be found at MyPlate.gov. While the app doesn’t sync with an account on MyPlate.gov, if you try to go by those standards, it does implement those guidelines pretty well. Food can be added to breakfast, lunch, dinner, and snacks, which is pretty typical as far as food diaries go. However, unlike on other food diaries I’ve used (such as MyFitnessPal,) it doesn’t break things down according to fat, carbs, protein, and sodium. Whenever a food is added, a graph changes, letting the user know how much more than can eat in a certain category that day (there are five sections – grains, vegetables, fruits, dairy, protien).

Below is a picture of the graph. It shows how many calories are left, as well as the percentages.

The app encourages users to try and eat “green” and “yellow” foods, and avoid the “red” foods, which is shown below for when the word “pizza” is searched. I think this is a good idea in essence, but I found that almost every food I added was “green.” Which would be fine, if everything I was searching was healthy, but I couldn’t find anything that wasn’t a “green” food. Even things that are obviously unhealthy, like ice cream and french fries. It might just be a glitch in the system, but hopefully that will be fixed. I think it would be interesting to see the “yellow” foods especially.

Overall, this is a very simple food diary. It doesn’t incorporate exercise, which may or may not be a plus for some people. For me, I like that. With food diaries I’ve used in the past, whenever I added exercise, it would give me additional calories. And I would end up thinking, “Oh, I have 300 extra calories. That means I can eat a big bowl of ice cream.” Not probably the best idea.

It’s very easy to set up an account, and I think the calorie goals are more accurate than other food diaries I have used. I have calculated my ideal caloric intake for weight loss using different calculations in the past, and this app has come the closest to matching that (unlike MyFitnessPal…which tried to convince me that 1200 calories was the way to go. No thank you.) The integration of the MyPlate standards are pretty interesting. It’s a nice change to see what types of nutrients the foods I’m eating have, and if I’m getting enough (or too much…darn those grains!) of a certain section.

There are a few things that should be improved. First and foremost, the database really doesn’t have the greatest selection. Something I love about MyFitnessPal is that it has seriously EVERYTHING. I mean, I typed in Costco samples before, and it had several entries for that. Quite often, I’ve found there to be foods from obscure restaurants I went to, which is cool. That isn’t the case with Healthy Food Guide. It has foods from a few restaurants, as well as most common foods, but it definitely has room for improvement.

Also, even though I don’t mind the absence of the exercise tracker, it may attract more users if that was implemented somehow. It might also be nice to have information regarding fat and sodium somewhere, just for those who do need to keep careful track of those factors. Incorporating social media might be nice as well, and the ability to add friends might be nice too, but obviously not a necessity for everyone.

All in all, it’s a nice little app for those who want something simple. I like the emphasis on selecting the right choices, and not just aiming to stay under a certain calorie goal. The description in the Google Play Store basically says, you can eat six chocolate candy bars all day and stay under your calorie goal, but that doesn’t mean it’s helping toward a healthier lifestyle. It moves beyond the basic idea of calorie counting, and places more of an emphasis on healthy eating. The app still in it’s early stages, so it cannot be expected to be perfect, but, it’s free, and I think that’s a cost anyone can afford just to try it out. It’s exclusively available for Android devices and can be downloaded here.