SAS: Over the healthcare horizon

Innovation, collaboration focus of 6th annual SAS Healthcare and Life Sciences Executive Conference

Some good video of John D. Halamka M.D and National Cancer Institute Director John E. Niederhuber speaking at this conference from SAS.

More on this in a bit but I'm still focused on Iran at the moment.

2009 Illinois Blogger Conference

See you there....

Uwe Reinhardt: The German Model

More Uwe here. This time on the German system.

The Buck Stops Here: Health Care Costs

More on this post later. Nuff now to say it points to the ethical choices it will be tough for Health Care reform to get its arms around.

Bob Brewin: Army medical center successfully tests health records system

From Bob Brewin's What's Brewin.

CHICAGO--The Madigan Army Medical Center in Tacoma, Wash., has completed a successful test of personal health record systems that allowed patients to access information contained in the Defense Department's AHLTA electronic health record system. Now the pilot project will be extended to the Navy National Medical Center in Bethesda, Md., and a civilian hospital system serving military patients in Virginia, Madigan officials told the annual Healthcare Information and Management Systems Society conference here this week.

He's been all over this.

Uwe Reinhardt: Defining ‘Health Care Reform’

Reinhardt brings his usual clarity to the dismal science. This time on Health Care Reform,

As a vertical economist, however, I naturally think of health care as just another economic sector with the following distinct facets:

1. a demand side (by which I mean patients or their agents, private and public health insurers, who procure health care and pay for that care)

2. a supply side (the providers of health care and of health care products)

3. a health-insurance system, intended to protect individuals and households from excessive financial loss due to medical bills, and also to help patients procure health care at negotiated prices

4. an information infrastructure supporting and linking patients, insurers and providers of care with one another, and

5. a regulatory infrastructure intended to keep transactions in this market honorable, fair to both sides, and oriented toward the ultimate social goals of a health system.

Ambitious as he is, the president would like to reform all of these facets of the health sector.

Read all of him.

More EHR

UPDATE 1-New military electronic records to be model for US includes the helpful paragraph chock full of links.

The White House did not say whether a commercial company would help design the electronic medical record system.

There are many that design such systems, including Cerner Corp (CERN.O), Eclipsys Corp (ECLP.O), Global Med Technologies Inc (GLOB.OB), Quality Systems Inc (QSII.O) and Allscripts-Misys Healthcare Solutions Inc (MDRX.O), IBM (IBM.N), General Electric Co (GE.N), Siemens AG (SIEGn.DE) and McKesson Corp (MCK.N).

Wal-Mart Inc's (WMT.N), Sam's Club unit is offering individual doctors a package including software and Dell (DELL.O) computers.

Experts say any national system would have to connect easily to other systems while protecting privacy.

...and now we know the vendors we'll be investing in.

Geek Doctor

Added a new informatics blog: Geek Doctor. He has a nice post on the elements of an EHR.

Helps to know what we're going to be investing a bundle into.

Tony Blankley: Daschle-Obama Health Care Possibilities

TB's column on Daschle's book.

What followed is my favorite line in the book: "When the test revealed a narrowing of the artery, however slight, cardiologists couldn't resist doing something about it." Imagine a doctor trying to cure his patient.

Cardiologists may have thought they were carrying out their responsibilities. But under the Daschle(/Obama?) plan, political hacks appointed to the Health board will decide whether your cardiologist is allowed to image your arteries and, if they find blockage, try to treat it successfully.

But that is not all he doesn't like about private-sector health care. On Page 174, he points out the dangers of letting drug companies advertise their products to the public: The public may want the drugs even if some Washington bureaucrat likes another drug instead.

He believes that Americans are not entitled to just any care that might do some good. Yep, Page 122: "Many patients with insurance want any care that might do some good, and plenty of doctors will oblige them."

Max Baucus: Call to Action Health Reform 2009

Senate Finance Committee Chair Max Baucus’s Call to Action Health Reform 2009 Baucus's Call asserts this on page 16,

Large employers — especially firms paying high wages — have the greatest capability to provide coverage to their employees. The vast majority of American employers in this category would probably continue to provide coverage as a competitive benefit to recruit employees. If these employers choose not to provide coverage, under the Baucus plan they would have to contribute to a fund that would help to cover those who remained uninsured.

I'm not optimistic large employers will find competitive benefits offering coverage. Just like post-invasion Iraq, the Senators may want to contemplate some other scenarios should the probables in this call not pan out.

Physcians as Theocrats

Nick Cohen on British GPs. So much for MD accountablity and performance measures.

For instance, it feels almost blasphemous to criticise doctors. With the decline of religion, they have replaced the clergy as confessors and comforters. The media still treat them as the protectors of the NHS’s soul, even though the money they are sucking out of the service has put at risk the future of health care free at the point of delivery. British GPs are now the best paid in Europe. Their average annual income is £106,000, while a few are making £250,000.

As ‘Dr Crippen’, the anonymous author of the NHS Blog Doctor site, put it: ‘The really high-achieving entrepreneurial GPs do not waste time seeing patients. They employ others to do that… the extra money has been earned by hitting government targets [which] have little to do with health care, but a lot to do with “process” and bogus but quantifiable “healthcare achievements”.’

The Department of Health’s blundering has overpaid GPs by £300m a year, about half the current deficit of the NHS. A scandal? Not if you read a medical press that defends the phenomenal rise of GPs’ salaries as furiously as the Daily Telegraph defends Goldman Sachs bonuses. When Nicholas Timmins of the FT wrote a mild piece for the British Medical Journal that politely asked whether GPs deserved their pay rise, furious correspondents thundered that CEOs got huge salaries, so why shouldn’t they.