Wednesday, December 24, 2008

Health Care Community Discussion Results - Part I

“Prevention needs to be a force in the health care system,” said one of the participants at the Health Care Community Discussion that I recently conducted. Prevention was a theme of our discussion. The Obama-Biden Transition Team is interested in knowing if attendees are familiar with the types of prevention services American should receive - mammography, flu shots and cholesterol screening - and had they gotten the recommended prevention. I’m glad to report that all the female participants have had a mammogram and all participants had flu shots and cholesterol screening this year.

Another participant said that “Health care begins at 65,” elaborating that once Medicare kicks, people are more likely to seek health care services since many were uninsured or underinsured.

Another area of concern is the disorganization and lack of integration of health care services. Electronic medical records, and particularly personal health records, along with improved health IT systems was offered as a solution.

The Obama-Biden Transition Team is interested in compelling personal stories from attendees about the need for health care reform. One participants said “I had to breakdown [caused by bipolar disorder] to get help. I needed a diagnosis before getting good care.” Another member of the group conveyed a story of newborns that were given a drastic overdose of medication.

More results to follow.

Thursday, December 11, 2008

Health Care Community Discussions

A few days after the election, the New York Times ran an article that included the following “Health Care – An Overhaul Will Have to Wait.” Today President-Elect Obama announced Senator Tom Daschle as Secretary of Health and Human Services AND Director of the [new] White House Office of Health Reform. Obama said “the time has come this year in this administration to modernize our health care system for the 21st century…If we want to overcome our economic challenges we must also finally address our health care challenges.” Perhaps health care will not have to wait after all.

Obama and Daschle intend to “make health care reform an open and inclusive process…to bring Americans into the conversation from the grass roots up.” To that end they are encouraging us to hold Health Care Community Discussions and to invite friends, family and colleagues to participate. And so I decided to do just that. Tom Daschle will be attending some of the Health Care Community Discussions and when I filled out the form on I made a compelling case for him to be at mine. Stay tuned. I’ll let you know if he’ll be there and I’ll let you know how it went.

Sunday, October 26, 2008

Vax and Vote

One of the things I enjoy about my work is the variety of projects with which I get involved. Heidi L. Hoffman, MPH (Health Care Consulting and Management Support) asked me to work with her on a project to develop an Immunization Action Plan for the Massachusetts Department of Public Health. She was engaged by MDPH who received a grant from CDC to support this initiative. The goal is to increase adult and adolescent immunization rates in the Commonwealth.

So there I was on Friday morning at Shrewsbury, MA Town Hall with a diverse group of health care professionals (providers, payors, administrators, etc.) all of whom are committed to getting out the vax . This was the first of five regional meetings that MDPH is conducting around the state. We’re looking for input from various parties about the strengths and weaknesses of current efforts to increase immunization rates and the opportunities and obstacles to doing so. All health care is local and this is exemplified by “Community Immunity” a campaign we heard about that the City of Worcester Board of Health has implemented.

Several non-traditional ideas came out of the meeting about how to make access to flu shots convenient. Vax and Vote was one of the more innovative ones. Why not get your flu shot at the same location where you vote? For now, get out and vote AND get out and get vaccinated.

Sunday, October 19, 2008

Back to the Future, Forward to the Future

Personalized Medicine: Hi-Tech, Hi-Touch, Maximum Engagement. That was the title of the conference - hosted by The Massachusetts Health Data Consortium - which I attended on Friday.

One of the topics was Concierge Medicine which most certainly falls into the hi-touch category - house calls, same day visits, doctors on call for their own patients. Personalized medicine that is reminiscent of another era, of times gone by. Albeit, as pointed out by one audience member, Concierge Medicine is limited to those who can afford to pay a significant out-of-pocket fee.

Then we heard about Personal Genomics. Definitely hi-tech and yet how much more personal can you get than having full knowledge of your own genes? A different kind of personal, however. One of the speakers pointed out with optimistic excitement that the combination of genetic test results and electronic health records means that doctors don't have to see patients in order to diagnose and treat them.

Perhaps we need to go back to the future where face-to-face patient-doctor relationships can thrive and couple that with the forward to the future promise of genomics. I’m encouraged by the possibility that this allows for a shift away from reactive medicine to early detection, and better yet, preventive medicine.