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  • Amazon Server Outage Raise Questions for Cloud in Health IT
    Posted on: http://www.healthcarecapitalist.com/


    Amazon Server Outage Raise Questions for Cloud in Health IT
     
     
    Amazon's much-touted server service called EC2 provide storage space for many business and personal websites, including well known names like Foursquare, Quora, Hootsuite, and Reddit. Last week, Amazon's EC2 servers went down and many websites, including those above, were rendered unusable for as long as two days.
     
    Many in the consumer technology as well as the health IT space have predicted that "cloud computing" (where information is stored and accessed from online servers) is the future. In addition to services named above, other prominent cloud products include Facebook, Gmail, Google Docs, and Mint. 
     
    I use Quora and Hootsuite everyday. While it was annoying to not being able to explore questions on Quora or send scheduled tweets on Hootsuite, the server outage did not affect my job or my academics, things that matter. The Amazon server issue has caused an uproar in the social media consumer community, but I believe the problem will pass. 
     
    However, if cloud computing were to be the future of health IT, what would happen when a server went down and EMRs cannot access medical information? All medical data would be inaccessible. Can hospitals afford to lose data access for all of its patients for anymore than 48 hours? Or six hours? Or even...one minute? 
     
    To learn about EMRs, my ONC-sponsored health IT course is using PracticeFusion, a 100% online cloud EMR. It'll be interesting to see if they come up with any solutions to problems like Amazon's. 
    Tags: AMZN
    May 05 3:52 PM | Link | 2 Comments
  • Does Every Hospital Commit Medicare Fraud? (THC, CYH)
    Posted on: http://www.healthcarecapitalist.com/
     
     
    Does Every Hospital Commit Medicare Fraud?
     
    That was the question in my mind when Tenet Healthcare (NYSE:THCsued Community Health Systems (NYSE:CYH) for illegally overbilling Medicare.

    Estimates put the effect of Medicare fraud at 3% to 9% of the total $431B in Medicare costs, implying that it's a systematic problem within the US healthcare system. Popular methods range from billing for services not rendered to upcoding procedures to more expensive ones. Many kinds of Medicare fraud is difficult to identify and hence quantify. It's even possible for hospitals to unintentionally commit Medicare fraud.

    So does this mean every hospital is potentially contributing to Medicare fraud? For hospital managers, is it possible to build a solid defense against fraud accusations if the problem itself is so hard to gauge? 

    Those keeping an eye on the issue:
    • This legal battle proceeds within the context that since December 2010, Community has been adamant about acquiring Tenet with a hostile takeover bid. This latest clash is seen as a way for Tenet to fight back.
    • Last Friday, 5 days after the lawsuit, the US Dept. of Health and Human Services, which manages Medicare, requested documents from all of Community's hospitals. 
    It seems that the Tenet lawsuit has cast a cloud of suspicion and fear over the entire for-profit hospital sector. Stocks for all major operators are down for the previous week, including not only THC and CYH, but also HMA, UHS, and the recently IPOed HCA.
     
    Apr 18 12:56 AM | Link | Comment!
  • Investors' POV: Scoping out Health IT
    Posted on: http://www.healthcarecapitalist.com/


    Investors' POV: Scoping out Health IT
     
     
     
    Today, I listened to the recorded presentation given by a panel of health information technology (HIT) leaders at the recent JP Morgan Healthcare Conference (Jan 10-13). The panel included:
    • Eric Schmidt, CEO of Google
    • Todd Park, CTO of HHS and Athenahealth co-founder
    • Anish Chopra, CTO of the US government
    • John Doerr, partner, Kleiner Perkins Caufield & Byers
    My reasons for sharing this is that HIT is transforming so quickly that it's helpful to hear both public and private sector panelists get on the same page. Also, HIT has the potential to affect every stakeholder -- payers, providers, pharma, legislators, and patients--in healthcare. (Of course, don't forget the investors.)
     
    This presentation marked the first time ever that the JPM Healthcare Conference hosted a health IT panel in its 29-year history, named "Innovation Opportunities for the Health IT market driven by HITECH and the Affordable Care Act". It may be been more appropriately titled "What Are the Incentives to Making Money in Health IT."
     
    Note: To listen to the session for yourself: Edit: The webcast can also be directly viewed here, via Vimeo (Thanks to Ahier). Or, visit the JPM webcast site, enter your info, and find the session "Innovation Opportunities for the Health IT market" under the Keynote section.
     
    Here are some highlights from the panel:
    (Due to the conversational nature of the webcast, many quotes couldn’t accurately be attributed to their authors)
    • "Meaningful use….is a presidential priority...[is] a shift of incentives for physicians..."  Anish Chopra 
    • "[Now's] the best time to be an entrepreneur at the intersection of healthcare and IT." 
    • "I can think of several new companies…has the potential to be multi-billion dollar companies."
    • "Meta-tags…and interoperable is key" Eric Schmidt
    • "Figure out a way to get the consumers [patients] to love the product [EHRs]. How? Patients care about their health" Eric Schmidt
    • "When the doc says you have some long-named disease, you type it in Google and BOOM now you can discover all the other diseases you may have." Eric Schmidt
    • "Meaningful use is an appetizer… bait. Payment reform is the entree...current structure is [Fee for Service]...you get what you pay for. Payment reform needs to change."
    Amusing exchange during Q&A:
    • British gent: "How about also liberating banking data of patients so we can know if a patient has bad behaviors like buying unhealthy food, so that the information can be used in treatment."
    • Eric: "I'm pretty sure what you suggested is illegal.”
    Overall, the tone of the panel was one aimed at championing HIT and to woo a room filled with deep pockets. When asked about the risks of investing in HIT startups, Anish Chopra answered that the risk was "very low." I would disagree with this as I feel the current environment is actually rather high risk due to changing policies, dominance from the incumbents (Epic/GE/McKesson/Cerner, etc), and the lack of interoperability. The question should be is the reward high enough relative to risk.
     
    Eric Schmidt repeatedly called for interoperability of HIT systems, and as he should since Google is the king of organizing (and monetizing) massive data sets. He also seemed to imply that the status quo of HIT incumbents was the reason for sluggish progress on interoperability. I would've liked to see him expand on the topic by making a business case to motivate incumbents.
     
    Overall, there was positive energy in the room during the panel, and one thing everyone agreed on was to "follow the money."
    Tags: ATHN, GOOG, CERN, GE, MCK, JPM
    Feb 14 4:36 PM | Link | Comment!
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