A compilation of essential news for the ACO and Medical Home markets.
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1. S u mme r 2 01 1 -Ju lyInformation Advantage Groups
Healthcare Digest is focused on the emerging delivery models
andtools for the hospital-to-consumer continuum. In a fast-read
format, we provide only the vital newsthat is essential to keeping
you current on the latest and most notable trends, ideas,
research,results, technological developments and helpful resources.
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abstract title to go to source.MACRO TRENDS DOJ SAYS MOST ACOS WONT
HAVE ANTITRUST Q1 GDP A DJUSTED U PSLIGHTLY PROBLEMS CONSUMER AND B
USINESS CONFIDENCE SLIPS NEWLY RELEASED - CMS ACO HELPFUL RESOURCES
BY FAR, MAJORITY OF A MERICANS ARE STILL HAPPY MARKETERS CAN MISS
THE LARGEST P ERCENTAGE OF MEDICAL HOME BUYERS FIRST ONCOLOGY
MEDICAL HOME REDUCES A SHIFT TO THE RIGHT THE MAJORITY (52%) OF
HOSPITALIZATIONS SOCIAL NETWORK USERS ARE 36+, YOUNGER SHOWS ONLY
35% OF UNDER 20 PHYSICIAN PRACTICES USE STEEP DECLINE MEDICAL HOME
PROCEDURES COORDINATION OF CARE I MPROVES WITH EHRHEALTHCARE MACROS
NEWLY RELEASED - HELPFUL R ESOURCES: IDC STUDY: H EALTHCARE IS THE
MOST ATTRACTIVE US MARKET HIE HOSPITAL SERVICES COST CONTINUES TO
RISE YEAR THE AMERICAN ASSOCIATION FOR FAMILY PRACTICE OVER YEAR
LAUNCHES LOW-COST MESSAGING SERVICE (HIE) $8,100 PER MAN, WOMAN AND
CHILD IN 2009 MAINE PASSES OP-OUT HIE R EQUIREMENT MOST HOSPITALS
PREPARING FOR THINNER MARGINS LESSONS LEARNED FROM CONNECTING TO
AHIP COUNTERS AMA CHARGES THE NATIONWIDE HEALTH INFORMATION NETWORK
MCKINSEY QUARTERLY: E MPLOYERS WILL PUSH TO (NWHIN) DROP
TRADITIONAL COVERAGE NEWLY RELEASED - HIE HELPFUL RESOURCES: EXPECT
E MPLOYER-BASED R ETIREMENT PLANS TO BE RETOOLED PHYSICIAN &
PROFESSIONALS HEALTH SAVINGS ACCOUNTS GROW 14% PATIENT EXPERIENCE A
LONG LIST OF ROOM FOR EMPLOYERS WILL INVEST MORE IN
WELLNESS/FITNESS IMPROVEMENT IN THE TYPICAL OFFICE VISIT PROGRAMS
BETTER PHYSICIAN-TO-PATIENT COMMUNICATIONS IS THE NEXT GENERATION
OF MOBILE APPS TO OFFER THE KEY TO IMPROVING P ERCEIVED Q UALITY
VIDEO HOUSE CALLS CANADIAN PHYSICIANS RECEPTIVE TO PHRWITH THE
WORLDWIDE MOBILE HEALTH PROJECTS EARLY USUAL CONCERNS DAYS,
RELATIVELY LOW T ECH VA PHYSICIANS STILL USE WORK-A-ROUNDS WITH
MINNESOTA PIONEERS ALLIED HEALTH WORKFORCE EHR EXPANSION 19% OF
PHYSICIAN USING TABLETS CLINICALLY PATIENT LIKE I PAD EDUCATION
VIDEOSACO EARLY F EDERAL ACO PILOTS FALL SHORT ON RETURN
PATIENT-CONSUMER -CAREGIVER AND COSTS PWC: CONSUMERS WILL SPEND
$13.8 BILLION OF CALIFORNIA HYBRID ACO PARTNERSHIP SHOWS $15.5
THEIR OWN MONEY MILLION IN SAVINGS CONSUMERS WILLING TO PAY FOR NEW
GENERATION KPMG SURVEY: MOST P ROVIDERS A RE STILL OF HEALTH
DEVICES THINKING ABOUT AN ACO, MOST PAYERS DON T HAVE MEDICAID
PRICE CONTROLS LIMITS CHILDREN A STANCE GETTING CARE HFMA: 12
ESSENTIALS FOR ACO SUCCESS REPORT YOUNG CANCER PATIENTS SPEND A
LMOST FOUR TIMES PHYSICIAN ALIGNMENT IS THE MOST CRITICAL STEP AS
MUCH AS THOSE WITH OTHER CHRONIC FOR DEVELOPING AN ACO CONDITIONS
TOP FIVE: ALIGNING PHYSICIANS FOR THE ACO NEWLY RELEASED -
PATIENT-CONSUMER-CAREGIVER HELPFUL RESOURCES Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 1
2. BOOMERS NEED EDUCATION ON HOW TO CARE FOR FCC CALLS FOR
COMMENT ON GRANDFATHERED THEIR PARENTS RURAL TELEMEDICINE PROVIDERS
NEW BILL EASES TELEMEDICINE REQUIREMENTS FOROVERSIGHT -INFLUENCE
-INNOVATION VETERANS HEALTHCARE REGULATORY: TECH & INNOVATION:
FDA MEDICAL D EVICE DATA SYSTEMS (MDDS) ACO REGULATIONS TO BE U
PDATED PATIENT-CONSUME21 MACRO TRENDS Despite ayoure on the bus,
youre off the bus economy, we are remaining a happy bunch of
Americans (81%) in the face of renewed slippage in our personal and
business confidence. What is also interesting is that the older we
are the happier we seem to be getting. With 58% of us being outside
the traditional 25-54 years of age demographic and the largest
group (9%) being the 70+ and then considering the shift to 52% of
those using social networks being 36+ years (a 58% increase since
2008), we can expect some wise rethinking about how to reach those
who buy, use and provide the most healthcare.Q1 GDP ADJUSTED
UPSLIGHTLYThe U.S. Department of Commerce delivered a bit ofgood
news June 24th, announcing that real GDP growthduring the first
quarter of 2011 was higher at 1.9%(final reading) than its prior
estimate of 1.8% provided amonth ago and Wall Streets estimate of
1.8%, but down fromthe 3.1% of Q4, 2010. The small upward revision
was due to anincrease in net exports, the changes in private
inventories,decreases in state and local government spending
andnonresidential fixed investment countered these increases.(US
Bureau of Economic Analysis, June, 2011) TopCONSUMER AND BUSINESS
CONFIDENCE SLIPSBased on data through June 16th, 2011, the
ConferenceBoards Consumer Confidence 58.5 reading is lower thanthe
consensus estimate of 60.8 and a decline from theMay reading of
61.7 - the lowest reading since December2010. This reflects a less
favorable assessment of currentconditions and continued negativism
about the short-termoutlook with fewer consumers than last month
seeingconditions improving over the next six months. Information
Advantage Group, San Francisco, IAG.co, 415.346.3860 2
3. The University of Michigan Consumer Sentiment Indexfor June,
2011 came in at 71.5, down from the 74.3in the previous month.And
finally, the NFIB Business Optimism Index of smallbusiness
sentiment falls in line with the previousconsumer confidence
indices.Doug Short sees these consumer and small businesssentiments
as remaining close to levels associated with otherrecent
recessions. The good news is that the trend sincethe Financial
Crisis lows has been one of generalimprovement and it is too early
to call whether thelatest monthly data will subsequently be seen as
areversal.Given the combination of uneasiness about theeconomic
outlook and future earnings, consumers arelikely to continue
weighing their spending decisionsquite carefully.(Advisors
Perspectives, June 28, 2011) TopBY FAR, MAJORITY OF AMERICANS ARE
STILLHAPPY81% of Americans are happy. Of those, 33% of 2,184
Americans are very happy thisyear - slightly down from the 35% who
were very happy in both 2008 and 2009 - according to a May, 2011
poll by Harris Interactive. The Harris Happiness Index is
calculated byasking how Americans agree or disagree with a list of
statements like: "My relationships with friendsbring me happiness",
"I rarely worry about my health" and "At this time, Im generally
happy with mylife" or "I frequently worry about my financial
situation" and "I rarely engage in hobbies and pastimes Ienjoy."The
poll also showed: Mens happiness has been trending down since 2009
- 31% are very happy in 2011, down from 32% last year and 34% in
2009, Women are generally happier than men and slightly trending up
(36% vs. 35%) over 2010, African Americans are the happiest and
trending up from 40% who were very happy last year to 44% this
year, Hispanics are now less happy than they were last year (35%
vs. 39%) yet they remain happier overall than White Americans who
are steady at 32%, No surprise - the highest income bracket,
earning $100K or more per year, are the happiest group (37%) - most
interesting are the least happy who are those who earn just
slightly less, between $75K and $99.9K per year (29% very happy),
Older Americans remain happier than those younger, as has been the
case in all previous years - 50-64 years (37%) and 65 years (42%)
and older are very happy and Those who graduated from college are
happier (35%) than those with less (32%) who have never
attended.(Harris Interactive, June 22, 2011) Top Information
Advantage Group, San Francisco, IAG.co, 415.346.3860 3
4. MARKETERS CAN MISS THE LARGEST PERCENTAGE OF BUYERSAccording
to US Census and Neilsen data, 58% (180 Million) of the US
population is outsidethe traditional 25-54 age demographic - of
this the largest grouping by age is the 70+ at9%. Also, consumers
age 55 and older have nearly identical purchasing habits to those
age 25-54 inmany consumer package goods product categories. TopA
SHIFT TO THE RIGHT THE MAJORITY (52%) OF SOCIAL NETWORK USERSARE
36+, YOUNGER SHOWS STEEP DECLINEThe average age of social network
users rose between 2008 and 2010, according to Pew Research.Key
trends include: The percentage of social network users age 18-22
fell 43%, from 28% to 16%, The percentage of social network users
age 23-35 dropped 20%, from 40% to 32%, The percentage of users age
36-49 rose 18%, from 22% to 26% and Most significantly, the
percentage of users age 50-65 more than doubled, from 9% to 20%.In
total, 52% of social network users in 2010 were 36 years old and
up, a 58% increasefrom 33% in 2008.(Pew Research, June 16, 2011)
Top HEALTHCARE MACROS The $2.7 trillion healthcare market has
always been an attractive market for the simple reason that its
dependent on someone else providing and paying for it a natural
fertilizer for runaway costs. We also know that persistent high
costs and pending thinner margins (4% down to possibly -1%) are
forcing those who pay for and provide most of our care to be a bit
more collaborative. Information Advantage Group, San Francisco,
IAG.co, 415.346.3860 4
5. Its early, but the exciting parts of the current proposition
are the incentives to get the patient on a path of self-care and
monitoring that requires them to think more about how and what they
will pay and whos going to provide it personal responsibility seems
to be a key ingredient in this brand of reformulation.IDC STUDY:
HEALTHCARE IS THE MOST ATTRACTIVE US MARKETIDC States the FACTS: on
a purely economic basis, the U.S. market for health care isthe most
attractive single market in the U.S. because: $2.7 trillion spent
in the U.S. is on health care, which is now 17 percent of GDP and
rising, The total health-care IT provider spends on a global basis
is $25.6 billion: a mix of hardware, software and services - 40% of
that is in the U.S. and expected to be 53 percent by 2014,
Estimates say $700 billion in wasted time, energy and resources is
poured into health care, The 15 US hospital systems account for 29%
of the total hospitals in the country, and 27% of the total beds,
Because many providers have been able to recover about 30% of their
overall IT budgets by optimizing their data centers and
infrastructure, they are investing this in the CPOE, EHR and
analytics systems under reform, 43% of providers are accelerating
their investment in EMR to qualify in time for stimulus incentives,
and An additional 32 million Americans will in theory have health
insurance by 2019, and insurance companies are required to pay out
up to 85% of the revenue they take in premiums to actual patient
care.(CRN, June 16, 2011) TopHOSPITAL SERVICES COST CONTINUES TO
RISE YEAR OVER YEARThe U.S. Bureau of Labor Statistics reports:
Consumer prices for hospital services increased 0.8% in May up
slightly from Aprils 0.7% climb the prior month - a year ago, the
agencys index of consumer hospital prices increased 0.5%. The
hospital index climbed 6.3% during the 12-month period ended in May
compared with an 8.1% increase a year ago.(Modern Healthcare, June,
2011) Top$8,100 PER MAN, WOMAN AND CHILD IN 2009In an excellent
summary, the July, 2011 National Institute for Health Care
ManagementFoundations data brief Understanding U.S. Health Care
Spending concludes that annualAmerican health care spending hit
$8,100 per man, woman and child in 2009, for a totalof 2.5 trillion
dollars. Key points include: 5% of the US population is responsible
for almost 50% of all spending; conversely, 50% of the population
accounts for only 3% of spending. Despite the growing numbers of
those being treated for chronic conditions, spending distribution
remains highly concentrated. Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 5
6. 50% of national and 80% of private insurance premiums were
attributed to increase spending for hospital care and physician and
clinical services during the 2005-09 period. Rising prices per unit
of service eclipsed rising utilization rates as the largest cause
for recent expenditure growth. Leading drivers of rising unit
prices and higher utilization rates include advances in medical
technology, higher rates of chronic diseases and increased provider
consolidation and market power.(NIHCM, July 2011) TopMOST HOSPITALS
PREPARING FOR THINNER MARGINSResearch by a global consulting
company posits that the resulting shift in the payer mix (i.e.,
moregovernment, less commercial interests) will likely cause the
majority of hospitals to seetheir average 4% margin sink to -1% or
lower over the next decade unless they beginpursuing major
strategic changes now. This is because historically, the fiscal
health of U.S.hospitals and health systems has been precariously
supported by using profits from commercialhealth insurance plans to
cover losses generated when caring for the uninsured, or lower
reimbursedMedi/Medi patients (Medicare currently provides
approximately 30% of all reimbursements tohospitals -- nearly five
times the percentage of the American population that it insures).
Trendscausing this change include: Companies discontinuing their
employer-sponsored coverage plans, Companies not subsidizing
employees healthcare benefits on health insurance exchanges, It may
be cheaper to pay government penalties than to provide employee
coverage at all, The decrease of employer-sponsored coverage will
swell the ranks of lower-reimbursement Medicaid membership by 16-18
million individuals during the next decade, and The wave of "baby
boomers" will continue to increase Medicare membership at roughly
3.1% per year.The dramatic shift to a much larger percentage of
government reimbursements willsubstantially reduce profitability
for most hospitals and health systems (despite thereduction in bad
debt associated with fewer uninsured).(Marketwire, June 20, 2011)
TopAHIP COUNTERS AMA CHARGESAmericas Health Insurance Plans (AHIP)
released research on June 8 supporting theobservation that hospital
systems are growing more dominant in their markets and thuscausing
cost increases. The idea is that doctors and hospitals are behind
cost increases has beena consistent theme of AHIPs public position
on reform and health care public policy for years. According to
AHIP, 80% of 335 markets studied would be considered highly
concentrated by the Dept. of Justice and the Federal Trade
Commissions Herfindahl-Hirschman Index - agencies use the index as
a guide during merger review. AHIP-commissioned research in 2009
showed that hospital consolidation between 1997 and 2006 drove up
the countrys health care spending by one-half of a percentage point
- $10-12 billion annually. Hospital consolidation is not a new
problem. From the late 1990s to 2003, these consolidations affected
90% of people in densely populated locations where the hospital
market qualified as highly concentrated.AHIPs statements counters
other, including the American Medical Association, reportsand
statements arguing that increasing health plan market consolidation
is the reason why Information Advantage Group, San Francisco,
IAG.co, 415.346.3860 6
7. premium rates have been going up even as physicians have had
to accept lower rates.Consistent research undertakings by the
American Medical Association have indicated thatthe market for
health insurance is highly concentrated in virtually every
metropolitan areaof the country. AMA has reported that one insurer
controlled 30% or more of nearly every market, based on enrollment
data from Jan. 1, 2008.(Amednews, June 8, 2011) TopMCKINSEY
QUARTERLY: EMPLOYERS WILL PUSH TO DROP TRADITIONALCOVERAGEAlthough
the Congressional Budget Office estimated that, under reform
measure, onlyabout 7% of employees will have to switch to
subsidized-exchange policies in 2014 fromtheir currently
employer-sponsored insurance (ESI) programs, in a February 2011
survey1,329 U.S. private sector employers undertaken to measure
their attitudes about healthcare reform,as well as other
proprietary research, found: 30% of employers will definitely or
probably be offering ESI after 2014 - this rises to more than 50%
and will push 60% to pursue some alternative to traditional ESI
among those considered to have high awareness of reform. 30% of
employers would gain economically from dropping coverage even if
they completely compensated employees for the change through
offering other benefits or higher salaries. If ESI was stopped, 85%
of employees would remain at their jobs, but about 60 percent would
expect increased compensation.(McKinsey Quarterly, June 2011)
TopEXPECT EMPLOYER-BASED RETIREMENT PLANS TO BE RETOOLEDAccording
to the sixth annual Employer Survey on Retiree Medical Strategy by
Towers Watson: Nearly 60 percent of the retiree medical plan
sponsors cite the high cost of providing coverage and opportunities
under healthcare reform as the main reasons for retooling
retirement plans.Among these sponsors: 87% are examining the new
federally-subsidized insurance options under reform for pre-age 65
coverage, 73% cite the Cadillac Tax for high-end plans as a
concern.So far, approximately 5% of employers have stopped group
plan sponsorship entirely andswitched to helping Medicare retirees
purchase higher-value medical and pharmacy insurance in
theindividual market through the use of Medicare
coordinators.(International Society of Certified Employee Benefit
Specialists, 2011) TopHEALTH SAVINGS ACCOUNTS GROW 14% The American
Health Insurance Plans(AHIP) association announced that more than
11.4million Americans are now using Health SavingsAccounts (HSA) -
a 14% increase since lastyear. HSAs are tax-exempt trust accounts
that arean alternative to traditional health insurance plans
Information Advantage Group, San Francisco, IAG.co, 415.346.3860
7
8. and offer employees lower insurance premiums if they agree
to place money into a special accountfrom which they pay for most
of their lower-cost, basic healthcare. These plans includea
catastrophic, high deductible insurance plan for larger medical
bills due to hospitalizations,surgeries, or other higher cost
specialized treatments.Based on their annual census, AHIPS January
2010 to January 2011 finds enrollment breaking outas: 2.4 million
lives for the individual market, 2.8 million lives for small-group
market and over 6.3 million lives were covered in the large-group
market. 26% growth for large-group coverage, making it the fastest
growing, with the individual market coverage coming in second at
15% The leading states include: California (1,073,319 enrollees),
Texas (844,832 enrollees), Ohio (728,868 enrollees), Illinois
(690,509 enrollees), Florida (656,243 enrollees) and Minnesota
(507,307 enrollees).(AHIP, June 14, 2011) TopEMPLOYERS WILL INVEST
MORE IN WELLNESS/FITNESS PROGRAMSA provision in the ACA law
earmarks $200 million for grants to help small businesses setup
wellness programs between 2011 and 2015. Some recent findings
include: 86% of employers plan to significantly increase wellness
and health promotion programs over the next three years and 56 %
improving employee health and 49% lowering healthcare costs topped
the lists of Hewitts 2011 Health Care Survey of 1,028
employers.(Boston.com, May 31, 2011) TopTHE NEXT GENERATION OF
MOBILE APPS TO OFFER VIDEO HOUSE CALLSIncreasingly over the last
year, insurers have begun offering mobile apps, largely
foradministrative functions, aimed at patients. Payers like United
Healthcare and HealthNetalready provide mobile access to coverage
and benefits information, physician directories, healthsavings
account balance totals and even out-of-pocket drug cost data. More
inventive companieshave expanded to mobile apps for fitness and
wellness tracking, localized allergy alertsand game-based social
media apps for fitness challenges.What is on the horizon includes
health apps that engage the patient with games that
areinstructional, challenging and also have the addictive component
of video games. MicrosoftsKinect is one of these systems that are
just now being explored for exercise and fitness.For the physician,
we can expect the current shift of mobile apps from consumerto
biomedical measurement to continue. We can also expect payers to be
looking to build"collaboration" apps that allow network physicians
to communicate via Smartphone with patients,send secure messages to
other providers, and receive alerts, results and "video house
calls."( FierceMobileHealthcare, June 17, 2011) TopWORLDWIDE MOBILE
HEALTH PROJECTS EARLY DAYS, RELATIVELY LOWTECHA recent World Health
Organization study on mobile healthcare (mHealth) states: Nearly 50
percent of the mHealth projects underway around the world involve
telemedicine, Information Advantage Group, San Francisco, IAG.co,
415.346.3860 8
9. Although worldwide mHealth is growing exponentially, theres
no organization to it, The biggest problem with this growth is
that, while 83% of the 112 countries studied have mHealth projects
ongoing, most are pilot projects with only 12% of these evaluating
the success of their mHealth programs, Europe (and the U.K.,
specifically), are the leading mobile-enabled countries when it
comes to healthcare; Africa has the least mHealth involvement, and
Appointment reminder (71%) is the most common use for mobile
devices in high-income countries; in low income countries the two
mHealth applications are lower-tech health call centers (59%) and
emergency phone services (54%).(FierceMobileHealth, June 10, 2011)
TopMINNESOTA PIONEERS ALLIED HEALTH WORKFORCE EXPANSIONMinnesotas
lack of rural physicians has opened the door for mid-level
practitioners totake on a greater role in providing health care.
Called community paramedics, this newcategory of healthcare
personnel targets underserved rural areas. Most of us accept
nursepractitioners and specially-trained nurses to perform physical
exams and prescribe medications.Whats new is the idea of using
mid-level practitioners to fill health care gaps. An example
isMinnesota being the first state in the nation to license "dental
therapists," who perform duties that fallbetween those of a dental
assistant or hygienist and those of a full-fledged dentist - they
can fillcavities and other simple procedures, under the supervision
of a licensed dentist. Or, it is also thefirst state to pass a law
establishing certification for community paramedics who might
suture awound, adjust a medication, or address an asthma attack or
allergic reaction.(MPRNews, June 20, 2011) Top ACO Objections on
the proposed rules for ACOs (as they are written) are often seeded
with the less than glowing results from federal ACO pilots where
only 40% of physicians got a shared savings bonus. The truth is, -
the pilot did slow Medicare spending across the board. Other
refined ACO-like pilots have been turning in good results. This has
most looking for the best way to structure and align with the
developing ACO model.EARLY FEDERAL ACO PILOTS FALL SHORT ONRETURN
AND COSTSA key government five-year test of the ACO conceptenlisted
10 leading health systems around the country andoffered financial
bonuses if they could save enough bytreating older patients more
efficiently while providinghigh-quality care: By the last year of
the study, 2010, only 40% of the long-established groups run by
doctors, slowed their Medicare spending enough to qualify for a
bonus. Two sites saved enough to get bonuses in all five years;
three did not succeed even once. Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 9
10. Other work has shown that the financial investments for
infrastructure and re-engineering have been higher than the
government has predicted, causing it to lose moneyfor at least the
first few years. The ACO rules will be final in December and much
moreresearch is needed on these cost and return issues.(NCPA, June
8, 2011) TopCALIFORNIA HYBRID ACO PARTNERSHIP SHOWS $15.5 MILLION
IN SAVINGSFour years ago, Blue Shield of California, Catholic
Healthcare West and Hill PhysiciansMedical Group partnered to form
their version of an ACO in response to concerns aboutrising health
care costs and their effect on policyholders. Now in 2011, the
partnership said forCalPERS 41,500 members have seen: Health care
spending was reduced by $15.5 million in 2010, Premiums did not
rise between 2009 and 2010 and There was a 15% reduction in the
average length of hospital stays and readmissions.The partnership
stated that much of the savings were created by eliminating
duplicative positionsand jointly funding new positions to make care
more efficient. They also indicated that it didntrequire a
significant amount of capital to start their
partnership.Headquartered in San Francisco Catholic Healthcare West
(CHW) is the fifth largest hospitalprovider in the nation and the
largest hospital system in California. It has stated that it does
notintend to participate in the federal governments ACO efforts
because as the rules arewritten, the bar is currently set too high
for the incentives offered.(California Healthline, June 27, 2011)
TopKPMG SURVEY: MOST PROVIDERS ARE STILL THINKING ABOUT AN ACO,MOST
PAYERS DONT HAVE A STANCEIn April, KPMG polled leaders of
healthcare systems, hospitals and healthcare payers about
theirparticipation in the Centers for Medicare and Medicaid
Services shared savings program (MSSP) the Medicare ACO program and
found that most are still thinking about it. 64% of hospital and
health system executives either didnt know their organizations
position (39%) or were in a wait-and-see mode (25%) about
participating in the MSSP - either position wouldnt allow them to
be ready for the launch of the program, planned for January 1,
2012. 61% of payers said they didnt know what their organizations
stance (50%) was or were in a wait-and-see mode (21%) on the
MSSP.(Healthcare Financial News, June 30, 2011) TopHFMA: 12
ESSENTIALS FOR ACO SUCCESS REPORTHFMA 2011 Leadership report
describes Baylor Health Care System 12 ACO essentials forsuccess
that focus on people, quality, and finance and include: 1.
Effective and Shared Governance 2. Aligned and Efficient Clinical
Workforce 3. Informed and Skilled Participants/Workforce 4.
Interoperable, Data-Enabled Environment 5. Quality 6. Attribution,
Assignment, and Capacity Management Information Advantage Group,
San Francisco, IAG.co, 415.346.3860 10
11. 7. Anchored Patient-Centered Medical Home 8. Care
Coordination and Patient Compliance 9. Risk Assessment and
Acceptance 10. Cost Monitoring and Reduction 11. Provider Reward
Methods/Incentive Design 12. Sustainable Business Structure(HFMA,
2011) TopPHYSICIAN ALIGNMENT IS THE MOST CRITICAL STEP FOR
DEVELOPING ANACOA recent survey of 882 administrators and
physicians highlighted that, while capital,infrastructure and data
analytics are key structural components regarding both ACOformation
and the industry-wide effort to enhance quality of care and reduce
costs,physician alignment was most pivotal: 58% stated they are
either in the process of forming ACOs or are thinking about it - of
these, 42% said physician alignment is the most serious obstacle to
their efforts, followed by lack of capital (38%), lack of
integrated IT systems (31%), and lack of evidence-based treatment
protocol data (25%). 42% will not form ACOs in the near future - of
these, 40% cited physician alignment as a reason they are not,
followed by lack of capital (31%), lack of integrated IT systems
(26%), and lack of evidence-based treatment protocol data
(23%).(MarketWatch, June 20, 2011) TopTOP FIVE: ALIGNING PHYSICIANS
FOR THE ACOPeggy Naas, MD, MBA, vice president of physician
strategies at VHA, Dallas, TX has one of thebetter lists for
developing strategies for successfully aligning physicians with a
hospitalduring the creation of an ACO:1. Focus on clinical outcomes
being delivered efficiently and in a way that benefits the
entireorganization.2. Choose a specific model suited to the culture
of the enterprise: Employment -Hospitals can employ or contract
physicians as a step on the way to align them with the
organization. Co-management - Physicians are employed or otherwise
paid for administrative roles or clinical leadership tasks and
other administrative leaders would have or preferably share
outcome-based incentives. Clinical integration - Health systems and
hospitals partner with health system-employed and self-employed
physicians on specific performance metrics.3. Foster physician
leaders who can participate in committees; listen to them and start
nurturing theirunderstanding of the broader organizations work and
the perspective of the board," she says.4. Be visible in the
enterprise and transparent about the health systems or hospitals
performanceand outcomes, no matter what the outcome - positive or
negative.5. Create a culture conducive to alignment and experiences
involving collaboration.(Becker Hospital Review, June 27, 2011) Top
Information Advantage Group, San Francisco, IAG.co, 415.346.3860
11
12. DOJ SAYS MOST ACOS WONT HAVE ANTITRUST PROBLEMSAt the
Second National Accountable Care Organization Summit in Washington
June 27th, deputychief of the legal policy section/antitrust
division of the Department of Justice GailKursh, JD, stated: An ACO
will be considered legitimate if it is a clinically integrated
collaboration of otherwise independent providers and not a vehicle
for competitors simply to raise prices and Most ACOs would not have
problems with their legality under antitrust provisions on the
proposed rules.Under current proposed rules, to participate in the
Medicare Shared Savings Program, would-beACO collaborations that
have more than a 50% market share of a primary service area (PSA)
wouldneed to demonstrate that their percentage of the market does
not create market power oranticompetitive behavior. However, what
constitutes a clinically integrated collaboration remains tobe
figured out.(FierceHealth, June 27th, 2011) TopNEWLY RELEASED - CMS
ACO HELPFUL RESOURCESCMS Proposed Rule establishing ACO Program
DetailsRequest for Information Regarding Accountable Care
Organizations and the Medicare SharedSavings ProgramIRS Request for
Comments Regarding the Need for Guidance on Participation by
Tax-ExemptOrganizations in the Shared Savings Program through
ACOsImplications Regarding Antitrust, Physician Self-Referral,
Anti-Kickback, and Civil Monetary PenaltyLawsProposed Statement of
Antitrust Enforcement Policy Regarding Accountable Care
OrganizationsParticipating in the Medicare Shared Savings Program
MEDICAL HOME Objections about the proposed rules for ACOs (as they
are written) are often seeded with the less than glowing results
from federal ACO pilots where only 40% of physicians got a shared
savings bonus. The truth is, - the pilot did slow Medicare spending
across the board. Other refined ACO-like pilots have been turning
in good results. This has most looking for the best way to
structure and align with the developing ACO model.FIRST ONCOLOGY
MEDICAL HOME REDUCES HOSPITALIZATIONSConsultants in Medical
Oncology and Hematology, PC (CMOH), a private practice in
southeasternPennsylvania, has become the first oncology practice in
the nation to achieve level III recognitionfrom the National
Committee for Quality Assurance as an oncology patient-centered
medical home(OPCHM) with results that include: CMOH chemotherapy
patients ER visits are half the rate reported in another large
commercially insured population and 65% lower than their practices
own 2006 rate in 2006. Information Advantage Group, San Francisco,
IAG.co, 415.346.3860 12
13. CMOHs rate of hospitalizations per chemotherapy patient per
year has dropped by 43% since 2007.(Fierce Health, June 14, 2011)
TopONLY 35% OF UNDER 20 PHYSICIAN PRACTICES USE MEDICAL
HOMEPROCEDURESA just released study in Health Affairs offer the
firstnational data on to what degree 1,344 medicalpractices with
fewer than 20 doctors had adopted theseven fundamental principles
of medical homeprocesses showed: Across all entities, only 35% used
medical home processes, and overall earned only 21% of the medical
home points, Adoption was greatest for the largest medical groups
(>140 physicians) and those owned by large entities like
hospitals and Contrary to the studies assumption, practices serving
a high percentage of minority or poor patients were not less likely
to be using medical home practices.With 35% of visits to US
office-based physicians are to solo practitioners, and 88% are to
practiceswith nine or fewer physicians, the study offers several
strategies to raise these scores.(Health Affairs, June 28, 2011)
TopCOORDINATION OF CARE IMPROVES WITH EHRA 12 month study of 119
patients, about half at Taconic Independent Practice Association in
NewYork State and the rest at eHealth Initiative, Sanofi-Aventis
and Health & Technology Vector, aHartford, Conn.-based health
IT and care redesign firm, the study found many processimprovements
in the care with the inclusion of an EHR in the workflow that
included: More information being transmitted to patients during
each clinic visit, more frequent setting of goals, and more
complete summaries being transmitted from primary care physicians
to cardiologists, Electronic communication between cardiologists
practices was problematic due to processes not being in place, the
communities did not have the tools for electronic data exchange,
and the providers did not have compatible EHR systems. However,
researchers also reported that some cardiologists were interested
in expanded exchange of electronic clinical data.Researchers
concluded that to be sustainable and successful, care coordination
requires ongoingand explicit three-way communication between
patient, primary care physician, and specialist.(Information Week,
June 23, 2011) TopNEWLY RELEASED - HELPFUL RESOURCES:American
Academy of Pediatrics: From pediatric to adult medical homes Joint
report outlines howto plan, execute better health care transitions
for all patientsThe Joint Commission has developed Primary Care
Medical Home which enables the potential forincreased reimbursement
when the additional requirements of a Primary Care Information
Advantage Group, San Francisco, IAG.co, 415.346.3860 13
14. HIE Were beginning to see more growth in privately offered
HIEs verses public to help physicians qualify under meaningful use
rules. Part of this shift is driven by a physicians affinity to
local affiliations, like hospitals and IPAs, and trade associations
way before governmentalhealthcare happens locally not regionally or
nationally.THE AMERICAN ASSOCIATION FOR FAMILY PRACTICE LAUNCHES
LOW-COSTMESSAGING SERVICE (HIE)The American Association for Family
Practice Physicians Direct is now available to itsmembers for $90 a
year. The service is intended to assist members meet meaningful
userequirements and is a secure clinical messaging system allowing
the sending of unlimited number ofmessages and data files to their
clinical colleagues and other trading partners. The system is
acollaboration with Surescripts, one of the largest electronic
prescription networks in the US.(AAFP, June 22, 2011) TopMAINE
PASSES OP-OUT HIE REQUIREMENTMaine has passed legislation requiring
healthcare providers participating in the states HIE to
provideinformative pieces that describes risks and benefits and how
to opt-out. This action is the resultsof a public hearing that
illuminated that a proposed op-in model had not garnered
supportfrom major stakeholders. The proposed legislation also
requires the HIE to offer online and offlineaccess to who, when and
where has accessed their records by patients. TopLESSONS LEARNED
FROM CONNECTING TO THE NATIONWIDE HEALTHINFORMATION NETWORK
(NWHIN)Lessons shared about connecting to the NwHIN were offered by
the North Carolina HealthcareInformation & Communications
Alliance Organizations during a recent webinar: Be prepared for an
abundance of interoperability testing and review before any
information can be exchanged, Be ready for the intensity of
developing and proving conformance and interoperability through
partner testing that all has to take, Governance must be in place
and must have the technical requirements installed first and then
the networks governing body must approve the entities for
interoperability and partner testing, and The cost of this is more
on the enterprise and community HIE side than it is on the gateway
connection to the NwHIN.Currently, those connecting to the NwHIN
must be federal agencies or have a contract with a federalagency
that covers these types of activities.(CMIO, June 20, 2011)
TopNEWLY RELEASED - HIE HELPFUL RESOURCES:HIMSS Electronic Health
Record Association, a vendor trade group, has developed a white
paperthat lays out a framework for health information exchange by
connecting EHRs more rapidly. Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 14
15. The eHealth Initiative has the second phase of its updated
HIE Toolkit that addresses creating asustainable model, technical
consideration of connectivity, marketing your HIE, auditing and
value-add services and working examples of documents and other
helpful materials. Top PHYSICIAN & PROFESSIONALS The attention
directed toward the physician-to-consumer market under all of the
new rules and models for healthcare have providers thinking hard
about how to gain efficiencies and improver the consumer
experience. Improved communication and patient participation and
collaboration through the use of technology are proving itself
again.PATIENT EXPERIENCE A LONG LIST OF ROOM FOR IMPROVEMENT IN
THETYPICAL OFFICE VISITIntuits April 2011 Health Patient Engagement
Study survey of 556 U.S. physician practices about thepatients
experience in their office found: Almost 25% of providers who are
not online think it is hard for patients to reach them to ask
questions, make appointments or receive lab results, Almost 50% of
physicians said their practices are typically running 30-60 minutes
behind schedule, 33% of a providers office staff spend three or
more hours per day trying to get follow-up information to patients,
83% of doctors say it takes more than one reminder before a patient
pays their bill, 45% say phone interruptions happen so frequently
they impact office efficiency. 72% say patients complain about
having to repeatedly fill out the same paper forms, and 50% say
their patients complain about spending too much time in the waiting
room.To improve on these inefficiencies: 95% of doctors want their
patients to fill out necessary forms online before their
appointment, 81% of patient agreed, 67% percent of providers are
planning to build add a patient portal, communication or EHR
solutions in the next 12 months under ARRA to provide patients with
access to health records and clinical information, appointment
scheduling and prescription refills.(HealthcareITNews, June 14,
2011) TopBETTER PHYSICIAN-TO-PATIENT COMMUNICATIONS IS THE KEY
TOIMPROVING PERCEIVED QUALITYCommunication between patients and
clinicians still follows in one-way direction from
doctor-to-patient. However, The New EnglandHealthcare Institutes
(NEHI) recent teleconference took a hard look at thiscommunication
channel and produced some valuable information andconclusions: The
ACA of 2010 includes a number of provisions that encourage the
development and use of shared decision-making and improved
patient-clinician communication. Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 15
16. The law also calls for the measurement of communications
quality and the information provided to and used by patients,
caregivers, and authorized representatives to inform
decision-making. Providers will increasingly be held accountable
for their communication with patients, as exampled by the current
use of patient satisfaction surveys (the Hospital Consumer
Assessment of Healthcare Providers and Systems survey), which are
currently part of Medicares Hospital Inpatient Quality Reporting
program and included under the measures for the first year of the
Value-Based Purchasing Program set to begin in October 2012 (FY
2013). As a guide for better patient-to-physician communications,
two work groups (the Evidence Communication Innovation
Collaborative and the Best Practices Innovation Collaborative)
under the Institute of Medicine Roundtable on Value and
Science-Driven Healthcare have developed a set of core principles
and expectations to communication. Early demonstration results show
that because patients are getting exactly what they want, providers
save time because patients come to appointments more prepared and
have greater risk perception.(NEHI, June, 2011) TopCANADIAN
PHYSICIANS RECEPTIVE TO PHRWITH THE USUAL CONCERNSA new study of
Canadian physician attitudes toward personal health records (PHRs)
discovered: Physicians generally saw PHR adoption as an inevitable
and positive step forward, Portability and potential to engage
patients especially appealed to the docs.Common concerns included:
Concerns about how PHRs could affect data management,
patient-physician relationships and practice management issues,
Security and privacy were top concerns, Unnecessary anxiety as
patients struggle to make sense of the complex information, if
information is shared without the conventional framing by a
physician,One conclusion by a physician about a patients use of
PHRs, If youre going to make (PHRs)worthwhile, you need to ensure
patients are able to interpret the information they are receiving,
ableto interpret it properly, and able to do something useful with
it; otherwise, you are going to createchaos.(iHealthBeat, June 14,
2011) TopVA PHYSICIANS STILL USE WORK-A-ROUNDS WITH EHRA new study
by the Veterans Administration showed that, even among practices
with advancedelectronic health record (EHR) systems, physician
workarounds persisted. Results included: Physicians used 11 types
of workarounds that included: printing out copies of instead of
viewing them on the screen, writing notes to help them remember
things, and building computer spreadsheets to keep track of
referrals. Communication breakdowns and some computerized consult
management redundancies were also discovered.(International Journal
of Medical Informatics, July, 2011) Top19% OF PHYSICIAN USING
TABLETS CLINICALLYAccording to a survey of 3,800 physicians, use of
mobile devices is growing rapidly: Information Advantage Group, San
Francisco, IAG.co, 415.346.3860 16
17. 83% of respondents own at least one mobile device, 25%
think of themselves as Super Mobile" who use a smart phone and
tablet device, 30% of respondent are using a tablet, 19%
clinically, The most common professional uses of mobile devices
are: look up drug and treatment reference material, learn about new
treatments and research, and search for information on diagnoses,
treatment paths, and educating patients. No age barrier to tablet
adoption, and a slight to moderate age barrier for smart phone
adoption, The iPhone (60%) was the most popular smart phone, and
the iPad was essentially alone in the tablet space, and Android
tablets were used by only a few.(QuantiaMD, June 15, 2011)
TopPATIENT LIKE IPAD EDUCATION VIDEOSPatients using education
videos on iPads atmoments of natural downtime during their
physicianvisits for 3 to 5 minutes and covering their diseasetopics
are being received well. Although its early,results show that the
modules have improvedpatient knowledge and generated positive
feedback without placing additional demands onphysicians or staff.
The videos were developed by Wake Forest Baptist Health and Wake
ForestUniversity School of Medicine.(AHRQ, June 2011) Top
PATIENT-CONSUMER -CAREGIVER The Consumer Miracle in healthcare
requires the patient-consumer to invest more of themselves and
their money in seeking a healthy life - another round of studies
are showing the patients willingness to do so and the consequences
on not.PWC: CONSUMERS WILL SPEND $13.8 BILLION OF THEIR OWN MONEYA
new report by PwC concludes that consumers would be willing to
spend approximately$13.6 billion a year of their own money on
healthcare services: Included in the $13.8 Billion is $4 billion on
health-related video games, $8.9 billion on consumer rating of
physicians and hospitals, and $700 million on mobile health
applications. Younger consumers (18 to 24) are twice as interested
in mobile health applications or programs and three times more
interested in health-related video games than those 65+. Demand for
convenience and transparency in services and pricing is spurring
alternative sources of healthcare services like retail health
clinics which grew from 10% to 17% over the 2007-10 period.(PwC,
June 2011) Top Information Advantage Group, San Francisco, IAG.co,
415.346.3860 17
18. CONSUMERS WILLING TO PAY FOR NEW GENERATION OF HEALTH
DEVICESA survey of 1300 consumers currently using wellness and
health devices and conducted by the IBMInstitute for Business Value
showed that consumers are demanding a new generation of
healthdevices, greater simplicity and better information sharing.
Leading reasons driving the buyare: 96% - ease of use is the key
factor in selecting one device over another, 75% - consider price
well ahead of features, customer support, warranty or stylish
design and 86% - want real-time, easy-to-understand feedback from
their devices.Moreover, the study finds, theyre willing to pay for
devices especially with $100 or belowprice point; and over 33% of
current device users expect to pay for part of the cost ofnew
health devices over the next two years and 35% also expect monthly
service fees.The report goes on to present a vision of key areas of
growth that include dieting, eldercare, bloodmonitoring, mobility
and communication. Here too the theme of collaboration rings for
vendors andcontent providers to work together to amplify the
utility of each device.(HealthcareITNews June 23, 2011) TopMEDICAID
PRICE CONTROLS LIMITS CHILDREN GETTING CAREA University Of
Pennsylvania, School of Medicine study found that children on
Medicaid wererefused appointments by 66% of specialists and had to
wait 22 days longer for anappointment than kids with private
insurance. The primary cause was seen as Medicaids pricecontrols,
which one survey reports 24 states plan to ratchet down even
further.(NEJM, June 16, 2011; National Governors Association
Survey, spring, 2011) TopYOUNG CANCER PATIENTS SPEND ALMOST FOUR
TIMES AS MUCH AS THOSEWITH OTHER CHRONIC CONDITIONSA recent study
in the Journal of Clinical Oncology found that 13% of non-elderly
cancer patientsin the U.S. spend more than 20% of their income on
healthcare, including health insurancepremiums. This compares to
almost 10% of non-elderly adults with chronic conditions other
thancancer and only 4.4 percent of non-elderly adults without any
chronic condition. TopNEWLY RELEASED -
PATIENT-CONSUMER-CAREGIVERHELPFUL RESOURCESThe National Prevention
Strategy is a comprehensive plan that will helpincrease the number
of Americans who are healthy at every stage of life. TopBOOMERS
NEED EDUCATION ON HOW TO CARE FOR THEIRPARENTSA survey of 600
Boomers aged 45-65 say theyre likely to become caregivers for their
parents, but...: Only 51% can name any medications their parents
take, 31% dont know how many medications their parents are on, 34%
dont know if their parents have a safe-deposit box or where the key
is, and 36% dont know where their parents financial information is
located.(Sun Times June 21, 2011) Top Information Advantage Group,
San Francisco, IAG.co, 415.346.3860 18
19. OVERSIGHT -INFLUENCE -INNOVATION There continues to be any
number of consumer health apps and devices entering the market
weeklywith few showing a sustainable business model. This has
hidden a shift away from pure consumer plays toward tools to
improve communication and care across the provider-consumer
continuum. The VA continues to promote telehealth while the
commercial and federal markets ask for more data the VA must know
something.REGULATORY:FDA MEDICAL DEVICE DATA SYSTEMS (MDDS)
REGULATIONSTO BE UPDATEDTheres a shift from mobile health apps and
devices being primarily consumerproducts to becoming useful tools
to connect patients and caregivers toclinicians. These tools are
expected to fall under FDA 501 (k) rules for medical devices when
theFDA begins regulating mobile health apps. Currently, the FDA
defines medical device data systems(MDDS) as hardware or software
products that transfer, store, convert formats, and display
medicaldevice data it does not control the device or modify the
data or its display.(Information Week, June 7, 2011) TopFCC CALLS
FOR COMMENT ON GRANDFATHERED RURALTELEMEDICINE PROVIDERSThe Federal
Communications Commission has adopted an interim final rule
toenable providers, who were "grandfathered" after the FCC changed
its definitionfor a "rural area" on July 1, 2005, to continue to
participate in rural telemedicineprograms that receive subsidized
telecommunications rates. The FCC iscurrently seeking comment on
whether to make these grandfathered providerspermanently eligible
for discounted telecommunication services.(Health Data Management,
June 27, 2011) TopNEW BILL EASES TELEMEDICINE REQUIREMENTS FOR
VETERANS HEALTHCAREThe Service Members Telemedicine and E-Health
Portability Act, also known as the STEP Act, wasadded to the
recently passed $690 billion Defense authorization bill. . Although
the legislation wasdesigned for mental health services, it will
help expand access to other types of medical care besidestelehealth
services to veterans across the U.S. In addition to making it
easier for providers to usetelehealth tools including video links,
cell phones and Skype, the bill would exempt care providersfrom
having to obtain a medical license in the patients state. Providers
still need to be licensed bythe Department of Defense.(iHealthBeat,
May 31, 2011) TopTECH & INNOVATION:Smartphone and tablet users
still using the desktop or laptop to access the Internet: 56.4% -
Desktop 39.6% - Smartphone 4.0% - Tablet Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 19
20. Rock Health, a seed accelerator for Web and mobile health
applications,has chosen ten start-ups from more than 350 entries as
part of its inauguralprogram. The chosen reflect trends that are
shaping the next generation ofhealth-related applications. The ten
are:1. BrainBot technology to improve mental performance;2.
CellScope at-home disease diagnosis;3. Genomera personal health
collaboration;4. Health In Reach medical procedure marketplace;5.
Omada Health clinical treatment social networking application;6.
Pipette patient monitoring and education;7. Skimble mobile fitness
application;8. WeSprout connecting health data and community; and9.
Three additional start-ups in stealth mode.The start-ups now enter
a 5-month program with funding in the form of a $20,000
grant;infrastructure; strategic medical, branding, communications
and legal support; and mentoring fromexperts.(Healthcare ITNews,
June 2, 2011) TopThe U.S. Department of Health and Human Services
(HHS) andthe Institute of Medicine (IoM) co-hosted their second
annualevent June 9th focusing on innovative applications and
servicesthat harness the power of open data from HHS and
othersources to help improve health and health care. Some
notableapplications included: iTriage - An iPhone app that allows
users to select their symptoms, severity, etc., and then the app
guides the user to a nearby clinic, physicians office, or hospital
based on his or her selections. Ozioma - A community-based app that
aggregates data from HHS, CDC, NIH, and other sources (65 sources
and 300 data sets in total). The app is for use by the press,
writers, and communications groups. Healthline - SPG (surgical
procedure guide) is a Web-based patient education application.
Users can learn about their procedure, view hospital-compare data
and costs and choose their doctor. Asthmapolis - Tracks where and
when people use their asthma inhalers. Shows on a map where and
when people have attacks - the app also improved asthma control
from 25% of the time to 62% of the time. CommunityCommons.org -
Connects individuals who are involved in the community health
movement.(HHS Live, HHS, June 9, 2011) TopThe Aetna Foundation, the
philanthropic arm of healthcareinsurer Aetna, has partnered with
the Health 2.0 Conference inSan Francisco on September 25-27, 2011
to issue a developerchallenge. The idea is to spur new interactive
browser-basedapplications designed to make data about obesity
moreaccessible and usable. The prize for the best application will
be $25,000 and two free passes to theconference. Second prize will
be $15,000, and third prize will be $10,000. Information Advantage
Group, San Francisco, IAG.co, 415.346.3860 20
21. (Healthcare ITNews, June 10, 2011) TopACOHealth information
technology company McKesson Corps healthinformation technology
group announced that it has signed a deal toacquire Portico
Systems. The acquisition will boost McKessonsofferings as a
provider of financial management tools for the ACOmarket which
calls for new products that support value-basedreimbursement
incentives to align payers and providers on controlling cost and
optimizing healthoutcomes. TopPATIENT-CONSUMER A new translation
app for mobile devices helps the hearingimpaired by enabling the
user to speak into a device andhave the translated text appear;
type-to-type translationsalso are available for situations that
require quiet or for thosewho have trouble speaking. The
application can support upto 1,000 voice recognition-based
transcriptions; text-to-text and text-to-speech transcriptions
areunlimited. $99. TopWith trend toward off-the-shelf computers
increasingly beingable to replace proprietary devices, Care
Innovations is a jointventure between GE and Intel with its first
product to be TheGuide, a table vital sign monitor and two-way
telehealthcommunication device. This is the first step in a
transitionaway from purpose-built devices and toward
device-agnosticmedical apps. It will run on any Win7 platform and
they wioll recruit other vendors to offer devicesthat best fit each
patients needs. TopThe No. 1 paid medical app in the U.S. Apple App
store is called Pill Identifier andworks by communicating with a
searchable database of pill images of more than14,000 prescription
and over-the-counter medications found in the U.S. 99 cents forthe
lite version $39.95 for the premium. TopThere has been an avalanche
of mobile applications both for the consumer andprofessional see
slide show: Information Advantage Group prepared this report as a
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Advantage Group, San Francisco, IAG.co, 415.346.3860 21