West Virgina Medicaid Initiative: Policy Meets Practicalities

Thursday 24 August 2006
David Harlow's HealthBlawg provides very interesting commentary on West Virginia's Medicaid Redesign efforts to implement change to the West Virginia Medicaid program, including pointing out a New England Journal of Medicine article, Personal Responsibility and Physician Responsibility - West Virginia's Medicaid Plan.

The article examines the practical realities of implementing a Medicaid plan that includes implementing consumer driven and patient responsibility components into a program that serves the most vulnerable sector of the West Virginia health care population -- the poor, uneducated, young/aged health consumer. West Virginacategory. The article also raises interesting questions about the role physicians play in the redesigned program and the fact that physicians will be faced with policy and ethical issues under the program changes.

A little Nick: I'm a liberal and a conservative, that I am as complex as the universe and as simple as a newborn child's cry . . .

Don't miss reading this post by my favorite hospital blogging CEO, Nick Jacobs over at Nick's Blog. Much of what Nick has to say strikes a chord with me and this post is a great example of his creative, optomistic and insightful look at health care and life.

Nick's statement of "everything in moderation" is something that I have heard forever (prize to the first Coffield reader who can cite the originator of this quote) and believe in. It's applicable to everything from diet to politics to work to play.

Just a taste. Enjoy the post:
This week a person called me to criticize me, accuse me of misdeeds because we were supportive of Mr. Murtha, and then he said, "Let me guess, you're a liberal?" The label was placed. (There's a lot of labeling going on in this country right now.) It is my belief that everything is relative. It is my belief that I am a liberal and a conservative, that I am as complex as the universe and as simple as a newborn child's cry.

When I asked my critic why he was convinced that the truths that he espoused were accurate, he proudly boasted into the telephone. "I listen to Rush." Let me assure you that "I don't listen to Rush, EVER." Mom always said, "Everything in moderation." Not too Republican. Not too Democrat. Not to fatalistic. Not too utopian.

During an exchange at a board meeting this week, I started a string of comments directed toward my board that went something like this, "We have $750,000 coming from grants, right?" My Foundation Director said, "Yes, maybe," and my Chief Financial Officer said, "It's not here yet." To which our board chairman replied, "Perfect, the Optimist, the Realist and the ACCOUNTANT." The next day we received the first $350,00 of the $750,000. Hah.

Executive Order Impacts Health Care

President Bush signed an Executive Order on August 22 requiring federal agencies to do more to inform public health care consumers about the cost and quality of health care services.

The Executive Order: Promoting Quality and Efficient Health Care in Federal Government Administered or Sponsored Health Care Programs directly impacts the Defense Department (military health care system), DHHS (Medicare and Medicaid), Office of personnel Management (Federal Employees Health Benefits Program) and Departmetn of Beterans Affairs (VA Health System).

For more information be sure to read the Fact Sheet: Health Care Transparency Empowering Consumers to Save on Quality Care which is linked with the Executive Order. Also, check out the most current discussion via Google News.

The important lesson from sandcastle building

Monday 14 August 2006
As I return to West Virginia after a week spent at the beach -- this post by Jim Carrol, Futurist, Trends & Innovation Expert, caught my attention. Much of my week on the sand was spent enjoying building sandcastles with my son, daughter and our friend's two children. All ranged in age from 2 to 6. I love the creative side of sandcastle building -- more so than most adults, I think. Jim's post titled, Why innovation thrives in sandcastle building," hit the mark for me.

I was also intrigued by Jim's recent comments on the 10 major health care and pharmaceutical trends. I'm not a regular reader of Jim's blog but have now added it to my RSS reader.

Thanks to Denise Howell for pointing me to this post. Don't move on until you click on the "sandcastle link" above highlighting some amazing sandcastle construction courtesy of Flickr.

Topsail Beach and Web 2.0

Sunday 13 August 2006
I've been off the grid for most of the week while spending time with my family and good friends at Topsail Beach, NC. Our family's first time at Topsail -- what a great beach community. The web access was limited but luckily I had my new Blackberry 8700c (I finally broke down and got a blackberry to give it a try) which allowed us to get to the grid to look up vital information like "how to skimboard."

On our way back to WV we are spending a few days in Chapel Hill with family and I'm now catching up with some backlogged grid reading. Coincidently one of the posts I read was by Matt Ballard, another West Virginia blogger who specializes in economic development for the Charleston Area Alliance. His post, "Trip to North Carolina Leads to Flickr Encounter," highlights and my finding it (and commenting) while in Chapel Hill further highlight in simple terms the powers of the new web 2.0 interaction and communication.

In conversation I often talk about the new people focused technology and what it means over the coming years. This new technology has been referred to as Web 2.0.

As a good starting point, Mike Arrington at TechCrunch has put together a 24 minute documentary on "What is Web 2.0?"

Interesting Statistic: Online Social Networking and the Health Care Industry

Tuesday 1 August 2006
"Among 21 year olds, 61% of web content created by someone they know."

Interesting stat courtesy of Denise Howell's attendance at Always On 2006. Interesting because I find myself more and more attracted to websites, blogs and other online content created by individuals I know or have met. This stat supports discussions with my nieces and nephews (all 20 somethings) who have grown up with and are more comfortable with online social networking including, text messaging, facebook, MySpace, Flickr, YouTube, etc. Interestingly, my 83 year old dad, a retired physician and resident historian of New Martinsville where I grew up, has become a regular on classmates.com sharing old high school stories and family information. This trend will only continue as they move into the workplace and beyond.

I'm interested in watching thie impact that online social networking will have on the delivery of health care in the United States. This is made all the more interesting by the aging baby boomers who are quickly moving into the largest users of health care (aka pig in python concept). For example:
  • More doctors and patients blogging
  • Online direct communication between patient and provider
  • Network aggregation of treatment information
  • Online support and communities of patients with specific diseases and the providers who treat them
  • Podcasting health information and medical advice
  • Videocasting health education or training for health care professionals
Scoble is on the same track with his recent comment that it's humans who optimize the web. He comments:

When I search on “Office Furniture” why is the first thing I see stores? I don’t wanna see freaking corporate info. I wanna know what HUMANS like to use in their offices. . . None of the big search companies have figured out that it’s the humans who “optimize” the Web. . . I’ll be looking for who lets me get to the other humans the fastest.
The younger generation and others who get it are trending in this direction and the web companies who answer will be the leaders. For another example of the shift in the younger (actually youngest) generation of web users take my 5 year old who yesterday wanted to order a costume for Halloween. Can't be too early for Halloween. He's been driving us crazy this week with an obsession for a particular costume. My wife and I finally collapsed and she asked him whether or not he wanted to call in the order or do it over the web. His response with a slight look of why are you even asking that was, "the internet . . . I want to see the costume." Then he said, "we can just Google it." His selection of web visual content vs. static telepphone audio struck me as interesting. This is the same 5 year old who who earlier this year we watch pull a Peter Pan video down and type in the words P-E-T-E-R-P-A-N from the cover into Google. He knew what he wanted even though he couldn't yet spell it out.

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Healthcare Blogging Summit 2006

For those readers who are health care bloggers or interested in becoming a health care blogger or better understanding the impact of blogging on the health care industy you may want to plan to attend the Healthcare Blogging Summit 2006 scheduled for December 11th in D.C. The event is being held in conjunction with the Consumer Health World conference.

The event is the brainchild of Dmitriy Kruglyak of The Medical Blog Network. The summit looks like it will be a great event based on the speakers lined up for various panel discussions. I plan to try to attend and meet in person some of the health bloggers I've communicated with.

If you blog on health care industry related topics take time and complete a survey being conducted by The Medical Blog Network and Envision Solutions called Taking The Pulse Of The Healthcare Blogosphere. The results will be released and discussed at the Healthcare Blogging Summit and should provide the first organized look at the state of the healthcare blogging community.

HITSpere: A Network of Healtcare IT Blogs

If you are interested in the latest on health care, medical and clinical information technology be sure to check out HITSphere, a network of healthcare IT blogs including my Health Care Law Blog.

HITSphere was founded and is managed by Shahid Shah who blogs at as The Healthcare IT Guy. Shahid describes the HITSphere as a healthcare IT blogoshpere launching pad where health IT blogs are aggregated and the HITSphere community that he is putting together can help bring out in the open the myriad problems in healthcare IT in a way that transcends technology.

Grand Rounds 2.45: Inside Surgery

Grand Rounds 2.45 is up at Inside Surgery.

I especially enjoyed reading long summer night by About a Nurse which provides a glimpse into the therapeutic nature and use of blogs by health care professionals. As a health lawyer I was struck by the implications posting about health care situations and how these conversations might ultimately make their way to court. I've yet to see a professional negligence case or a breach of privacy claim involving a health care practitioner who blogs about the event and then is either sued or called to testify -- but I am sure that day is coming.