Advocating through Inquiry

Please check out this new post I have written for Athenahealth's Leadership Forum.  It's called "Advocating through Inquiry" and relates some intriguing ideas from Gerald Hickson and his colleagues from Vanderbilt.  St. Francis makes an appearance, too.Please let me know what you think about it, either here or there.  Than...

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KHN explains why insurers cancel policies

Kaiser Health News has the best explanation of how and why insurers can cancel policies in the individual health insurance market.  Excerpts:News that health insurers are ending the policies of what could be millions of Americans has rattled consumers and added to the debate over the health care law. If you or a family member has been notified that your individual policy is being cancelled at year’s end, you may be stunned and upset.No one...

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A word from one of the 5%

The President's spokesperson today tried to explain why the President's statement--"If you like your health plan, you can keep it."--was true.Listen from minute 3:00."As the law says, and as the President made clear . . . if you had insurance coverage on the individual market when the Affordable Care Act was passed into law and you liked that plan and you wanted to stay on...

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Thanks, Professor Ocasio!

I want to thank Willam Ocasio, Kellogg professor of management and operations at Northwestern University, for saving me some money. He read my last post about my family's Blue Cross Blue Shield of MA plan under the Affordable Care Act and suggested that I could save "a lot of money" by choosing the $500/$1000 (individual/family) deductible plan instead of the plan with no...

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Didn't they promise lower costs?

Ross Douthat writes in the New York Times that Americans will soon be able to get "a real look at what Obamacare is selling them."What will they find? One way to understand what is being offered is to think in terms of three “mores.” Insurance à la Obamacare will be more expensive, more subsidized and more comprehensive than what was previously available on the individual...

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In memoriam: Marilyn Kass

Marilyn Kass, aka Momo, passed away last night after a long battle with breast cancer.  She has been an inspiration to many of us.  The humorous picture above was from a recent adventure in horseback riding.  Here's the message she has had on her blog--subtitled, "Breast cancer--It's amazing what you can get used to."Thanks for checking out my blog. For those...

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Pigs in service to America

The NSA probably knows this already, so I think it is all right to spread the word.I noticed in my blog statistics that someone from the Department of Homeland Security was looking at a series of my favorite Lean training blog posts.  They are about drawing a pig.  Hey they are: Part 1, Part 2, and Part 3.But I wondered what led them to these sites.  Well, the...

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World Series Symphonic Battle

A sweet interplay between orchestra members from Boston and St. Louis.  F...

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Halamka's correct about IS implementation

One of the best decisions I made before taking on the CEO job at BIDMC was to meet with John Halamka to make sure he would be staying on as chief information officer.  Once he said yes, I knew it would be safe to sign on, confident that our clinical and administrative information systems would be best of class.As you read this blog post by John, you can get a sense of his wisdom and common sense. The closer:Policies are good.   Policymakers...

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How to win at chicken

Do you recall the old game of chicken?  Two cars (driven by slightly crazy people) drive towards each other at high speed.  The person who swerves first--to avoid the pending collision--is "chicken" and loses.If we look at this as a problem in decision analysis, we find the following matrix of possible results.The question often posed about this game is how you can...

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Conversation Ready on WIHI

Madge Kaplan writes:The next WIHI broadcast — Who’s Conversation Ready? How Health Care Can Respect End-of-Life Wishes — will take place on Thursday, October 24, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Kelly McCutcheon Adams, LICSW, Director, Institute for Healthcare Improvement Lauge Sokol-Hessner, MD, Attending Physician, Beth Israel...

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Not leaping ahead

It is so striking that hospitals are keen to accept and publicize the results of the fairly meaningless US News and World Report hospital rankings--rankings that have no statistical validity and are based in part on rumors about the quality of care delivered--and yet complain bitterly when the Leapfrog Group posts scores based on data about preventable medical errors and injuries. ...

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A chip off the old block

When your father is Richard Corder, a fellow who spends a lot of his time helping hospitals become more patient-centric, you develop insights somewhat different from other 11-year-old girls.Richard (hungry and sitting at the kitchen table, just about to bite into a tuna sandwich his wife has thoughtfully prepared):Ah, this is just what the doctor ordered.Carrie (sitting across...

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Kicking Concussions

Personal adversity can sometime produce a commitment to change.  Caroline Cohen is a high school student in our town who suffered several concussions in sports activities, the most recently in 2011 during a Memorial Day soccer tournament.  Following that last injury, she was forced to miss school and, eventually, to give up all contact sports.To help spread the word...

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Solving two types of IT problems

Sometimes you hear an idea that is perfect.  Here's one from a loyal reader:My wife suggests switching NSA and HHS personnel -- two birds with one sto...

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How marketing works on the web

You have to hand it to the world's spam engines.  This comment came in within hours of my posts about the problems with the health insurance exchange site! (I've taken out the links.)CMS web design allows businesses to organize and maintain their website content fast and effortlessly. Besides, one can have an unlimited number of pages and a full site-search engine.Website...

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The health insurance exchange on 35 floppy disks

We can rely on The Onion to make us laugh out loud, even as we cringe a bit because of the underlying truth.  Here's an excerpt of their version of how the Administration is solving the health insurance exchange problem:WASHINGTON—Responding to widespread criticism regarding its health care website, the federal government today unveiled its new, improved Obamacare program,...

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First rule of governing: Stay on message

There is so much good in the Affordable Care Act, and I am confident it will have lasting value for the country.  There is an undeniable and important need for people to have health insurance and not be subject to arbitrary decisions by insurers about pre-existing conditions, coverage limits, and the like.  And those, after all, are the main features of the law.  But sometimes I wonder if the President has speechwriters who understand...

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Costs of Care Essay Contest is Back

Neel Shah has been running the Costs of Care essay contest for several years, and it is time to send out the reminder for the fourth annual event.  Here's the website. There will be $4000 in prizes for the best stories from patients, doctors, and nurses illustrating the importance of cost-awareness in healthcare.  The deadline for entries is December 1, 2013.Neel...

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Real improvements in concussion treatment

The CDC reports that approximately 200,000 sports-related concussed athletes per year end up in US emergency rooms.  The total number of sports-related concussions is five times that figure.  Whether the patients end up in EDs or not, our diagnosis and treatment of these traumatic brain injures is substandard compared to what might be possible.  I recently heard...

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Sunday Dialogue: Responses and Rejoinder

Artwork by Marion Fayolle at the New York TimesThe New York Times has reposted my initial letter to the editor in their Sunday Dialogue feature, plus responses to it, plus a rejoinder from me (at the end).  Check it out here or in your actual Sunday morning paper.My last word:As a general matter, if you can characterize an error or near miss by saying, “It could have...

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The Waiting Room comes to PBS

Excerpts of a note from Pete Nicks: We proudly announce that The Waiting Room finally hits TV screens nationwide on PBS' Independent Lens this Monday the 21st of October at 10pm! (check your local listings). It has been quite a journey since Bill Hirsch and Scott Verges, two local attorneys who wanted to make a film about the uninsured, hatched this idea...

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Misplaced priorities?

In an emergency, time matters, right?The following recorded message is currently being provided when you call a local primary care clinic.  It clearly was just dropped in before the regular message. There is no way to bypass it. Did someone forget about the medical emergency advice that usually comes up front, or was there a conscious decision to push it back?I understand the challenges that clinics face in providing clear, concise, and current...

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