Kim Bellard

See the following -

11 Things About Health Care I'm Dying to Redesign

The folks at Ideo recently published 19 Things We're Dying to Redesign, covering a wide range of products, services, and systems, both big and small.  It's very thought-provoking, but only one of them addressed a health care topic (oddly enough, incontinence). If there is an area of our lives that badly needs redesign, it would be health care. And not redesigning it sometimes literally results in us dying. Let's start with a clean slate. I'm not as ambitious as Ideo, in terms of the breadth or number of topics, but here are 11 things about heath care that I'm dying to redesign...

2017 Prediction: Some "Oops" Ahead

Predictions for 2017 are everywhere this time of year, and it is no wonder.  There are so many technological advances, in health care and elsewhere, and a seemingly endless appetite for them.  We all want the latest and greatest gadgets, we all want the most modern treatments, we all have come to increasingly rely on technology, and we all -- mostly -- see an even brighter technological future ahead. Here's my meta-prediction: some of the predicted advances won't pan out, some will delight us -- and all will end up surprising us, for better or for worse.  Like Father Time and entropy, the law of unintended consequences is ultimately undefeated...

America's Dismal International Rankings - Time to Innovate Our Way Out of Our Messes

Most Americans -- myself included -- think we live in the greatest country on earth. After all, we have the biggest economy, the most powerful military, the most pervasive popular culture, and, of course, the American Dream. We've got Wall Street and Silicon Valley, Walmart and Amazon, Hollywood and Nashville. We have -- well, we used to have -- the biggest city, the tallest building, and the largest manufacturing output. But when it comes to some of the basics, we're not doing so well. Take health care, for example. If you listen to politicians, we have the best health care in the world. And, indeed, if you have enough money (or really good insurance), happen to live in the right zip code, and manage to stumble upon the right doctors/hospitals, that's true. You can get the best health care in the world here.  But fail any one of those qualifiers, maybe not...

Are Smartwatches Being Over-Hyped as Health Trackers?

I don't get smartwatches. Yes, I know; they're all the rage.  Apple unveiled its Apple Watch earlier this month, to generally good if not entirely ecstatic reviews.  Not to be outdone, Google announced a collaboration with TAG Heuer and Intel for a "Swiss Smartwatch."...I have to wonder why the focus on the wrist.  It isn't the ideal place to track, say, your heartbeat, your sleep, or your steps, and as a result fitness trackers have been faulted about their accuracy.  Cramming features into a smartphone makes some sense, because they have become so ubiquitous, but I'm not sure who is clamoring to add more features to a watch...

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Artificial Intelligence Docs May Need Some Good AI Lawyers

A recent post highlighted how artificial intelligence (AI) is already playing important roles in health care, and concluded that expanded use of AI may be ready for us before we are ready for it.  One example of the kind of problem we'll face is: who would we sue if care that an AI recommended or performed went wrong? Because, you know, always follow the money. Last week Stanford's One Hundred Year Study On Artificial Intelligence released its 2016 report, looking at the progress and potential of AI, as well as some recommendations for public policy...

Asking Better Questions and Improving Patient Engagement

I've been thinking about questions. A few things I read helped spur this. The first was a blog post entitled "Asking the Wrong Questions" by Benedict Evans, of VC firm Andreessen Horowitz, Mr. Evans looked at a couple of long range technology forecasts (from as long ago as 1964 and as recently as 1990), and pointed out how they both managed to miss several key developments. He attributed this to "this tendency to ask the wrong questions, or questions based on the wrong framework." And we're still at it. Mr. Evans, whose background is mobile technologies, said that people are now doing a lot of speculating about what comes "after mobile," such as AR and VR...

Best Buy Buys Into Health

Best Buy generated a lot of positive press recently with its acquisition of GreatCall, which focuses on technology services for seniors.  Its move into health may not be a surprise since it seems lots of retailers -- think Walmart or Kroger -- and many big tech companies -- think Apple or Amazon -- want into health, not to mention more tech startups than you can throw $100 million at. It's the why and the how about Best Buy's moves into health that deserve more scrutiny, and that healthcare organizations may learn from.

Betting on Future(s) - Doctors vs Fantasy Football

Pundits worry about the chilling effect that medical school debt -- which approaches $200,000, according to the AAMC -- has on our future physician workforce.  If so, I'm wondering if health care should take a page out of a tactic being used for pro athletes: allow investors to buy shares of physicians' future income...To be honest, I'm not even really all that interested in securitizing physicians' incomes, even for those (relatively) poor primary care physicians.  Complaints about incomes aside, most physicians do quite well financially and, of course, much better than in most other countries.  What I'm interested in is having the data on physicians that such an approach would require.

Can the Healthcare System Change Its Spots?

Just a few years ago, things were looking up for the American health care system. We were going to start finding better ways to pay for care: call it pay-for-performance (P4P), value-based purchasing (VBP), or similar terms. We were going to nudge -- or, rather, push -- providers into more clinically integrated systems (e.g., ACOs) to help improve outcomes and to control costs. And, of course, with wider use of electronic health records (EHR), we'd be able to better coordinate care and make decisions based on actual data. It all sounded very promising. Now, though -- what's that old expression about the leopard not being able to change its spots?...

Clicks-and-Mortar: Health Care's Future

The woes of the retail industry are well known, and are usually blamed on the impact of the Internet.  Credit Suisse projects that 8,600 brick-and-mortar stores will close in 2017, which would beat the record set in 2008, at the height of the last recession.  There are "zombie malls," full of empty stores but not yet shuttered. And then there's health care, where the retail business is booming. In a recent Wall Street Journal article, Christopher Mims set forth Three Hard Lessons the Internet is Teaching Traditional Stores.  The lessons are: Data is King, Personalization + Automation = Profits, Legacy Tech Won't Cut It.

Computational Thinking in Healthcare

OK, you use your smartphone all the time: you use the latest and greatest apps, you can text or tweet with the best of them, you have the knack for selfies, and so on.  You probably also have a computer, tablet, and a gaming system, each of which you are also very proficient with.  No question: you are a whiz with electronic devices. But, if you're like most of us, you don't really know how or why they work. Maybe that's OK.  Most of us don't know how our cars work either, couldn't explain how heavier-than-air flight is possible, have no idea what the periodic table means to our daily lives, and would be in trouble if our lives depending on us making, say, bricks or glass...

Could Pokémon Go Help Fix Healthcare and Lead to Usable EHRs?

However promising gamification in health care may be, it is the AR that may well hold the most promise for health care.  Google was not wrong to pursue Google Glass, just premature. Pokémon Go may be signaling that we're now finally ready for AR, and that it will be consumers as well as professionals who can benefit from it. The potential uses in health care are virtually endless, but here are a few examples...Ever feel like your doctor spends too much time staring at your chart or a screen? Instead of looking there for information about you, how much better would it be if he/she was looking at you, with AR notations for key information about you?...

Crowdfunding for Healthcare

Elizabeth Rosenthal's searing article about medical billing, adapted from her forthcoming book An American Illness, is well worth a read.  Its topic of sophisticated medical billing/upcoding -- done by organizations ostensibly acting in the best interests of patients and often under the guise of a non-profit status -- is also worthy of a discussion itself.  This is not that discussion. What jumped out to me (and to many others, on Twitter and elsewhere) was the following indictment: "In other countries, when patients recover from a terrifying brain bleed — or, for that matter, when they battle cancer, or heal from a serious accident, or face down any other life-threatening health condition — they are allowed to spend their days focusing on getting better"...

Diagnosing the Problem with Direct-to-Consumer Pharmaceutical Ads

Quick: turn on the TV (no, streaming doesn't count!). You won't have to wait too long before an ad for some prescription drug comes on. Watch long enough and pretty soon you'll suspect that you have a variety of conditions that you may have never realized before and need to do something about immediately. Fortunately for you, of course, the pharmaceutical industry has solutions for you. It's all there in those ads. Whether we really understand them or not is another question. Direct-to-consumer (DTC) ads for prescription drugs are booming. After a brief respite during the most recent recession, they're back up, with spending estimated at some $5.2b in 2015 (amazingly, the DTC ads are less than 20% of pharma's overall marketing budget, with the majority of that going to face-to-face "educational" efforts with physicians)...

DIY Health to the Rescue

Experts often compare how slowly the health care system is "reforming" to how hard it is to turn a battleship.  They're so big that they can't turn on a dime (much less on $3 trillion!), and there is as much risk in trying to oversteer as in not turning at all.  Things are changing, we're assured, but it will take time to get on the desired new course. Maybe.  But maybe it is time to jump off the obsolete battleship onto something more nimble. Some call it Do-It-Yourself Health (there are both .org and .com sites devoted to the topic, among others).  PwC declared it to be one of the top ten trends of 2015.  Dave Chase believes that "DIY health reform is now leading the way for the highest performing reform" -- not Medicare, health insurers, not even employers...