Friday, March 28, 2008

Insights - Healthleaders Magazine - Insiders’ Insights

The March glossy issue of Healthleaders Magazine just hit my desk. Healthleaders is a Massachusetts based publishing firm that has a website,, a research firm, a conference giver, and a book publisher.

Their March issue’s cover story is “Your Hospital, The Entrepreneur, How Funding Early-Stage Ventures Now Can Yield Health Returns Later.” It features a story on hospital innovation. It talks of Ascension Health and its venture capital fund, and Vanderbilt University and its venture fund.

At Vanderbilt, William W, Stead, MD, associate vice chancellor for strategy and transformation and chief information officer, leads its innovation team. Says Stead, “It takes a particular mindset to be an effective entrepreneur. And there are a limited number of academic teams, certainly academic ones, that understand entrepreneurial people well enough to know how to lead them.”

Innovation runs in the Stead family. William Stead’s brother, Eugene Stead, MD, headed Internal Medicine at Duke, while I was a student, and he pioneered and founded the concept of Physician Assistants after observing that medics returning from Vietnam had great skills but nowhere to apply them.

But that's another story. T

he March issue also contains two “Insider Insights”, two short pieces on what health insiders think. One piece quotes me as editor of Physician Practice Options Old Saybrook. Connecticut, and the other citss Vince Kuraitis, principal of Better Health Technologies, LLC, of Boise, Idaho.

Here are our respective comments:

Reece: Doctors are highly skeptical about IT relieving the burden of their practice for a couple of reasons. One, with electronic medical records, they don’t seen any return on investments. Two, it disrupts their practice. And three, it costs too much, especially when you include maintenance of technology. That is one of the principal reasons only 10 percent to 20 percent of doctors in small practices have gone to EMRs, and only 20% communicate by e-mail. E-mail communication, in their minds, is not part of their normal practice flow, so they have not adapted to that yet. Some health plans do reimburse for time spent e-mailing – it’s seen as a way of giving patients more options. It’s an evolutionary thing, however, and we are clearly in the early stages.

Kuraitis: The current system is one that is totally designed to provide in-person are – and that is what they system is reimbursed for. The assumption is that is how care is delivered, and in the days that was a valid assumption. But now we are changing the assumption that care has to be delivered and/or reimbursed in person. As a result, doctors will be doing more virtual care, and the other part of the equation is that they’ll also be getting paid for it. It will be a change in the work flow, abut I would say it is good because we are chaning the though process on what is the optimal way to deliver care. For a lot of things, you don't have to be in front of a doctor. The new technologies will improve patient care because they have the potential to make doctors more competitive.

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