@health2con Better, Faster, Cheaper but we seem to have dropped Better.

The Wrap up from Health 2.0 Spring Fling.

Indu: How do we get to Better – How do we scale and achieve cost impacts. Stakeholders are starting to collaborate.
How do we match the people with the need to those with the solutions.
[Ed: That echos @DermDoc’s comment about engaging the Docs in the Health 2.0 movement]

How do we leverage collective learning. How do we reduce redundancies.

Matthew: Worried about spending $30B and not moving the needle in Health IT. It will take a lot of effort to change primary care. Research realises that their world has been blown up. We need to get the core of HealthCare to realize the same thing.

[Ed: Consumerization of Health leveraging Web, Mobile and Social will transform HealthCare dramatically. Are you ready?]

Health Innovation Week September 17-27th, 2011 in San Francisco.

Donate to the Health 2.0 Relief Fund. Got to FirstGiving.com

@health2con The last panel moderated by @HealthyThinker

How are We Going to Make a Difference?

Moderated by: Jane Sarasohn-Kahn Principal, Think-Health

For more than a day the discussion has been about how health care can be cheaper, how Health 2.0 can advance research, and what to do about our national (and international crisis) with lifestyle induced disease. In the final session, some key players will discuss their vision for the future of health care, and the role Health 2.0 will play.

Panelists:

Liberty is to the collective body what Health is to the individual – Thomas Jefferson

Consumers are the most under utilized resource in the health care system. And they vote 3 times a day + snacks.

Great panelists for the final session.

No one is big enough to be independent of others. – Father of Mayo Founders

David Rosenman giving Kudos to Washington for their leadership in health reform

Lygeia: We are not just treating the physical body. We have to deal with the emotional side. 

Margaret: How do we bring great entrepreneurs to Health Care. [Ed: it’s what we call http://healthca.mp]

David: Organizations can’t afford to be independent of others. The potholes are if organizations think they are big enough to act alone. 

Lygeia: Health 2.0 is a movement

Margaret: Taking ideas to demonstration. Then Taking Ideas to Scale.  We need to work on the latter.  How do Foundations invest with synergy. How do we create a sustainable innovation ecosystem. Great ideas to market adoption.

Stephen:  Improving health requires advocacy in other non-health areas. eg. housing standards. 
Health Impact Assessments for big developments.  RWJF popularizing the concept and developing guidelines and standards. Source data will be environmental and Observations of Daily Living – Not the Medical Record.

Now the final wrap up by Matthew and Indu

@health2con The final stretch – Making Health Care Cheaper

Making Health Care Cheaper

Moderated by: Matthew Holt, Co-Chairman, Health 2.0

Inspired by a keynote we heard some time back from Mark Smith at California Health Care Foundation and by the work of organizations such as West Wireless Health Institute, we???re going to push the envelope on how Health 2.0 technologies and the companies using them can actually lower the cost of health care. We???ll be showing new models for care delivery, new Health 2.0 technologies that reduce costs, and new technology models that take advantage of lightweight tools and rapid cycles for development and deployment. We will also address alternate funding models that are tailored for a lower cost, faster and more iterative approach in health technology innovation.

Speakers:

With Demos from and Conversation with:

GiveForward – like kickstarter for Health

Enabling people to raise money towards health costs. This helps families meet the non-covered costs for major health care events.
People can donate and leave words of encouragement.

Arnie Milstein Professor of Medicine and Director of the Clinical Excellence Research Center, Stanford University

The real cost of care is hidden to all that are involved in giving and receiving care. It is completely invisible.

[Ed: Saying that the Health Plan knows the cost is not exactly true. Surely it is the billing department in the hospital or Doctor’s office. They end up charging different costs based upon situation. Cash settlement, In network, out of Network, Medicare] 

Dealing with chronic diseases is 50% of costs in the US Health system.  

Things to do:
– Show that a patients health matters
– Make following a care plan easier
– Specialists vary in use of health resources to deliver care. We need help to measure care effectiveness.

Health Reform has made the Medicare data accessible. Opportunities for developers to make sense of this effectiveness data.

Primary Care Coaching model.  Focus on a subset of patients with multiple chronic disease. Key to engagement is a human being. instead of a Nurse in a call center they are in the practice to meet face-to-face with patients. 
The EMRs are useless – they don’t improve care or lower costs. Tools are need to help with outreach.
Need tools to monitor the population.

Consumer direct model. REinventing the payment and delivery model. Outside the insurance market. approx. $65/month in place of insurance.
This is typically coupled with a High Deductible Plan. The net savings are often around 50% when these costs are combined.

Their system reduces ER visits by 65%. Inpatient by 40%. Open 7 days/week and 12 hours/day to provide easy access.

Eric Langshur Founder and Chairman, Rise Health
Working with large hospital systems. We have a shortage of properly used primary care physicians.
Rise Health addresses cost and access. 
Using tech
nology to take low value tasks off the Doctors plate.

Why now – Because we have our backs against the wall. Cost increases are unsustainable.

We will see change if Medicare reimburses based on results rather than volume. Affordable Care Act is setting the stage for this.

Here are some lightweight technologies:
Jay Mason CEO and Co-Founder, MyHealthDirect

Working with Health Systems in the ER direct patients to more appropriate care settings.

Bettina Experton CEO & Founder, Humetrix
The patient’s Medical Card as their Health Record. USB flash card embedded in a card that can be the patient’s medical card. The software loads via USB to point to an online health record page.

Nice interface with BlueButton to enable doctor download of data.

 Arnie: we need tools to make it simpler. We need to go further. 

[Ed: what Arnie is saying – The Doc wants Ques to act on not be deluged with data.

The Humetrix Blue Button process just provides Data Deluge. There is a massive opportunity to provide Doctors with tools to manage the data deluge and enable them to act effectively on the essential data and the exception indicators.

Eric: We are pushing to replace Paper and Process Anarchy with Digital Anarchy.  No anarchy is the same across hospital systems. They each have their own anarchy.

Creating Infrastructure Independent Care.
Right Treatment, Right Time, Right Place.

SensorBaby – measures remotely at 96% of accuracy of hospital monitoring.
Bluetooth kit. iPad App to capture and display data. 

First deployment will be in Mexico. This can be deployed to trained health workers. The kits cost is around $150. Not yet FDA Approved.

Bart Foster CEO & Founder, Solo Health
Self service technology is popular with consumers. This needs to move in to health. 
Coinstar/RedBox just invested in SoloHealth. 
Kiosks are networked. You can use any kiosk. 

30M people a year are at risk of vision loss.

Arnie: Will improve access. Will they improve cost – TBD

Norm:  Data is invaluable in the Medical Home. 

Rushika: It is crazy how we manage chronic disease using 3 month snapshots in the doctor’s office.

Raw data streams are not useful but monitors that evaluate the stream and point out exceptions are useful.

@health2con @todd Park to award the winner of the Developer challenge

More from the afternoon session of Health 2.0 Spring Fling.

The Health 2.0 Developer Challenge Showcase

Moderated by: Indu Subaiya, Co-Chairman and CEO, Health 2.0

See winners from both the online Health 2.0 Developer Challenge and the most recent Health 2.0 code-a-thons.

With speakers including:

And announcing the winners of the Challenge:

20 Challenges have created about 130 submissions from teams.

HHS is at the forefront of releasing data to change HealthCare. This is historic and inspiring. Part of the 10 year Healthy People 2020 vision.

Want to make data come alive at the community level.

Challenge was to move from paper-based to web-based approach. HealthyPeople.gov is live

@ToddPark as vibrant and energetic as ever!

And the winner for the MyHealthy People Challenge is….

3rd: IQ Solutions – MyHealthyPeople
2nd: HHN Public HealthLine

and the winner is…
1st: Healthy Communities Institute

Next Challenge: Provider Quality 

Hospital Quality Compare CGI: http://health.cgi.com/hhshospital/default.aspx

Next Challenge: Community Cancer Challenge

Winners: 
– Geographic Awareness of Cancer Tool
– OZIOM – locally relevant cancer information to african american communities.

Indu: The Developer Challenge is agnostic to who poses or participates in a challenge.

Microsoft – Windows Azure Datamarket. Challenge is getting interesting underlying data. Worked with Practice Fusion.
“Democratization of Data” – Healthcare is the least democratized data set.

De-identify the data and expose to developers to discover trends.

Team Epicenter was the winner that used 15,000 Practice Fusion records.

Epicenter helps find, analyze and address emerging Epidemics.

Kristi Miller from American Heart Association. Optimal Cardio-Vascular Health. Good Food Choice.

Winner: FoodSwapper.

Health-based Food Swaps to help you reach your goals.

Amy Romano – Childbirth Connection – Maternity Care Quality

Team BigYellowStar is the winner.

The team have already launched a site to look at water quality.

And now for the live Code-A-Thons…

3 Cities: Boston, SF and DC
300 Attendees
20 Teams
8 finalists come to the Health 2.0 Spring Fling: http://ekive.blogspot.com/2011/03/health2con-developer-challenge-code.html

Boston was first attempt at DIY devices in conjunction with O’Reilly and MAKE:

People’s Choice Award:  Team Maya – Food Oasis Project addressing Food Deserts.

Runner Up: Team Free Health

Connecting people to free preventative services (as demanded under the Affordable Care Act)

And the Winner is…. Team Triangle

Using the Microsoft Xbox Kinect to diagnose abnormal motion problems.

This is an amazing use of consumer technology to solve a real and widespread problem.

There are still existing challenges running:
– Lucile Packard Foundation for Children’s Health. Go V
iral
– Engage With Grace.

@health2con – Future of Research

More from Health 2.0 Spring Fling 

The Future of Research

Sponsored by:
Microsoft

Moderated by: Indu Subaiya, Co-Chairman and CEO, Health 2.0

The emergence of user-generated content, and the rise of patient involvement in Health 2.0 is radically changing research in both discovery and clinical practice. It???s raising important questions. What is peer review? What is evidence? And what???s appropriate methodology in a world in which data are being generated and released from so many diverse sources so quickly? We???ll be looking across the spectrum from genomics to clinical trial recruiting all the way to clinical research and decisions made by providers and consumers in everyday practice.

Speakers:

Paul Wallace Medical Director for Health and Productivity Management Programs, 

Kaiser Permanente

What is the framework for thinking about Research.

What are we concerned about: Data
Who is involved: Researchers
How: ……

How do we change research while respecting the history and sociology of Research.
Research is an analogue world. 

Researchers find the question then go corral data to get to answers.

What is changing is that data is now being generated as a result of care. Data has gone from rare to abundant. From expensive to cheap.
This is profound disruption. 

Trust becomes an even more important element.

Research has a branding challenge. Research is becoming learning.

Only a few may be researchers but we are all learners.
Learning is influenced by roles and perspective. e.g. Doctor as Patient brings a whole new perspective.

Research is insight from data.
How do we take research cycles from 17 years to 17 minutes?

Josh Sommer Executive Director, Chordoma Foundation

Facing a life expectancy of 7 years and unwilling to accept this limit Josh started a foundation to move research forward.
Chordoma Foundation was established to promote collaboration amongst researchers.

Gone from a handful of researchers to 170 across the world.
Licensed cell lines to 30 labs around the world from a lab in Germany.
This is jump starting research.

2,000 patients with the disease. No one hospital sees a large number of patients. This doesn’t give critical mass in one place. The foundation helps to address this.

Access to funding
Access to raw materials
Access to Tools for collaboration

Just held the 3rd annual Chordoma conference. Sparks of enlightenment flew when different experts collaborated. [Ed: this is why http://healthca.mp is so important – the diversity of experience and perspectives]

Peer review process. 1-3 year delay due to submission and distribution process.

Patient Conference:  two parallel workshops – 1 for researchers and 1 for patients and their families.  Then get them to overlap.

On a campaign to get 1M women to contribute to Cancer Research
47,000 women die of Breast Cancer. Same as 20 years ago.
We need to move from cure to identify and eradicate the cause.

350,000 Women have joined (80% don’t have breast cancer)
Email blasts to this army. Dis-intermediate the medical industry. They don’t do research well. They get in the way.
Biggest complaint is that there is not enough research.
$1,500 to perform a study. Not typically clinical trials.
Starting to expand beyond Breast Cancer to other diseases.

George Lundberg Editor-in-Chief, Cancer Commons

Cancer Commons – a platform for collaboration.
Large clinical trials are deeply flawed. 
Many cancers may be genomically unique.

Population death rates 5% drop in 60 years. 

Cancer Commons is open source, real time research. 

600,000 Americans die of cancer each year.

Personalized Medicine = Genomically informed Medicine = Medical Research with a unit of 1 = What a doctor practices with his patients every day.

Gilles Frydman Founder, ACOR

(And a great participant in HealthCamp – http://healthca.mp )
ACCOR is the oldest listserv for cancer in the world.

ACCOR is partnering with 23andMe to give Cancer patients access to genomic information.
Even small incremental improvements (through initiatives like Cancer Commons) have big impacts. 

ACCOR helped Novartis speed up drug approval by 2.5 years. First year sales of $1B means the time saving had an enormous impact.

Paul Wallace Medical Director for Health and Productivity Management Programs, Kaiser Permanente

Clinicians sometimes push back against guidelines because it implies a de-personalization of medicine.
We are on the cusp of personalized medicine.  

[Ed: The patient’s data needs to be incorporated in to the data on which decisions are based.]

Now for  Demos from and Discussion with: