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Insurer Covers Telemedicine Virtual Visits

Insurance company UnitedHealthcare will start covering visits to the doctor's office — via video chat. Patients and physicians talk live online — on smartphones, tablets or home computer — to get to a clinical diagnosis. This move to cybermedicine could save insurers a ton of money — or have unintended consequences.

UnitedHealthcare's move to cover all or part of the cost of these e-visits — for up to 20 million customers by 2016 — is big. A major company is putting its stamp of approval on a process that, until now, has been largely experimental.

Read the whole article here.

#Telemedicine #UnitedHealthcare

Some Hospitals Try Treating Patients at Home

To measure the costs of patients who are hospitalized at home, patients will be followed for one month after their home hospital stay, during which they are eligible for services ranging from health coaching to home doctor visits. The team at Mount Sinai will collaborate with Dr. Leff and his colleagues at Johns Hopkins to compare outcomes to a similar group of patients who are hospitalized and to measure patient satisfaction.

Even for Mount Sinai, whose house calls program has been around for two decades, bringing the key elements of the hospital to a Manhattan apartment hasn’t been easy. A well-meaning family member of one of the first patients in the program decided to store her intravenous antibiotics in the freezer, rendering them unusable.

But before gearing up to enroll their first patient this past November, the Mount Sinai team arranged a complex system of backups. Patients have 24-hour physician and nurse coverage, and an arrangement with emergency medical service providers ensures that rather than reflexively transport all patients to the hospital if they are called, the providers will deliver all the care they can at home.

Read the whole article here

#population management #mount sinai #mobile acute care

Apple Watch Part of Ochsner’s Broader Strategy

While it doesn’t have the national profile of some health systems, Ochsner has been working hard to be a leader in digital medicine.

More than a year ago, the hospital launched an “O Bar” — deliberately modeled on Apple’s Genius Bar — to help patients pick through the thousands of health and wellness apps available to them.

Six months ago, Ochsner became the first hospital to integrate its Epic electronic health record system with Apple’s HealthKit software.

And in February, Ochsner launched its “Hypertension Digital Medicine Program,” a pilot program where several hundred patients regularly measure their own blood pressure and heart rate ratings using wireless cuffs, which then send that data through Apple’s HealthKit (and collects it in their medical records). Based on the results, Ochsner staff then make real-time adjustments to the patients’ medication and lifestyle.

The new Apple Watch trial builds off the hospital’s existing digital medicine program, Milani says. And he began Friday’s pilot with his longtime patient Andres Rubiano, a 54-year-old who’s spent the past twenty years trying to manage his chronic hypertension.

Rubiano says that his two months participating in Ochsner’s digital medicine program have been “comforting” — he enjoys the constant monitoring — and have already led him to make changes in diet and exercise.

Full article here

#apple watch #Ochsner #population management #digital medicine

Doctors and Leadership in Accountable Care Organizations

Physician leadership is widely seen as crucial to drive accountable care and population health, but the question is how. A recent survey of accountable care organizations (ACOs) across the country has shown significant interest and motivation by physicians for participating and playing strong leadership roles in ACOs.

There have been significant challenges with physicians providing effective leadership of population health programs:

- Physician-led population health services have not been achieving the overall outcomes and demonstrating value.

- Physician services have not been coordinated with the hospitals and health plans, leading to redundancy in population health initiatives.

- Front-line physicians have been perceived as being recalcitrant and uncooperative due to a fundamental lack of trust in the executive leadership regarding population health programs.

These challenges with physician-led attempts in population health management have resulted in these programs not being effective in managing costs and enhancing value. These trends have led to a great deal of skepticism about the potential of the new models of Accountable Care Organizations to have any better track record.

Read the study here.

#population management #ACO

Your good bacteria love stinky fromage as much as you do

Americans have long been bewildered by the French paradox: that despite consuming a dream diet full of cheese, baguettes and red wine, people in France have generally low rates of coronary heart disease. By some estimates, the average French person eats 57 pounds of cheese each year—more than in any other country—while the average American eats a measly 34.

#coronary heart disease microbiome cheese #TMAO