Episode 15 of “The THCB Gang” was live-streamed on Thursday, June 25th!
Joining Matthew Holt were our regulars: health futurist Ian Morrison (@seccurve), writer Kim Bellard (@kimbbellard), WTF Health Host Jessica DaMassa (@jessdamassa), radiologist Saurabh Jha (@RougeRad), policy expert Vince Kuraitis (@VinceKuraitis), and THCB’s Editor-in-Chief, Me (@zoyak1594)! We got into increasing COVID-19 rates, updates in health policy, what is the future of hospitals, and how the new generation is dealing with the health care industry. All while keeping an eye on the politics of the US.
If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan
By VINCE KURAITIS, ERIC PERAKSLIS, and DEVEN McGRAW
This piece is part of the series “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?” which explores whether it’s possible to advance interoperability while maintaining privacy. Check out other pieces in the series here.
A worldwide dialog about COVID-19 contact tracing is underway. Even under the best of circumstances, the contact tracing process can be difficult, time-consuming, labor-intensive, and invasive — requiring rigorous, methodical execution and follow-up.
COVID-19 throws curve balls at the already difficult process of contact tracing. In this post we will provide some basic background on contact tracing and will list and describe 10 challenges that make contact tracing of COVID-19 exceptionally difficult. The 10 unique challenges are:
1) COVID-19 is Highly Contagious and Deadly
2) Contact Tracing is Becoming Politicized
3) We Lack Scientific Understanding of COVID-19
4) Presymptomatic Patients Can Spread COVID-19
5) Asymptomatic Patients Can Spread COVID-19
6) Contact Tracing is Dependent on Availability of Testing
7) Contact Tracing is Dependent on New, Extensive Funding
8) Contact Tracing is Dependent on an “Army of Tracers” and Massive Support for Patients
9 ) The Role of Technology is Unclear — Is it Critical Support or a Distraction?
10) The U.S. Response Has Been Fragmented and Inconsistent
The thrust of this post is about traditional boots-on-the-ground contact tracing conducted by public health agencies. We will touch on a few aspects of digital contact tracing (e.g., smartphone apps), but we’ll go into much more depth on digital contact tracing in future posts.
How does contact tracing relate to the theme of this series — The Health Data Goldilocks Dilemma? It’s about obtaining the right amount and types of information — not too much, not too little. Not too much data so that privacy rights or civil liberties are infringed, or that contact tracers are overwhelmed with useless data; not too little data so that public health agencies aren’t handcuffed in protecting our safety in tracing COVID-19 cases.
Episode 13 of “The THCB Gang” was on Thursday, June 11th. Watch it below or on our YouTube Channel.
Matthew Holt (@boltyboy)was back on the moderating chair! Joining him were patient advocate Grace Cordovano (@GraceCordovano), patient safety expert Michael Millenson (MLMillenson), policy expert Vince Kuraitis (@VinceKuraitis), MD & hospital system exec Raj Aggarwal (@docaggarwal), data privacy expert Deven McGraw (@healthprivacy) and fierce journalist & data rights activist Casey Quinlan (@MightyCasey). This was a doozy, and the conversation ranged from what it’s like re-opening at a big academic medical center to data flow and public health in Taiwan to statues of Confederate losers in Richmond. Not to mention what will happen in the impeding second wave.
If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan
Episode 10 of “The THCB Gang” was live-streamed on Thursday, May 21th
Joining me were regulars: writer Kim Bellard (@kimbbellard), policy expert Vince Kuraitis (@VinceKuraitis), patient advocate Grace Cordovano (@GraceCordovano), radiologist Saurabh Jha (@RogueRad), employer consultant Brian Klepper (@bklepper1), Deven McGraw (@healthprivacy) and a guest, former ONC Consumer head Lygeia Riccardi, now at Carium Health (@Lygeia)! The conversation moved onto the new normal of telehealth, how much things would change in the future, and what the story with testing and opening up would look like. You can see the video below
If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels — Matthew Holt
Episode 8 of “The THCB Gang” was live-streamed on Thursday, May 7th at 1pm PT- 4pm ET! You can see it below.
Joining me were our regulars: patient advocate Grace Cordovano (@GraceCordovano), data privacy lawyer Deven McGraw (@HealthPrivacy), policy expert Vince Kuraitis (@VinceKuraitis), radiologist Saurabh Jha (@RogueRad) (who snuck in late), and writer Kim Bellard (@Kimbbellard). We had a great conversation including a lot of detail around access to patient records, and some fun about infectious disease epidemiologists behaving badly! If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels from Friday— Matthew Holt
Episode 6 of “The THCB Gang” was live-streamed on Thursday, April 23 at 1pm PT- 4pm ET! 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the sh*t about health care business, politics, practice, and tech. It’s available below and is preserved as a weekly podcast available on our iTunes & Spotify channels.
Our lineup included: Saurabh Jha (@roguerad), Ian Morrison (@seccurve), Kim Bellard (@kimbbellard), Grace Cordovano (@GraceCordovano),Vince Kuraitis (@VinceKuraitis), Brian Klepper (@bklepper1), and a special guest – Alexandra Drane (@adrane, founder of Eliza, Queen of the Unmentionables, CEO of ArchAngels and sometimes Walmart cashier). Lots of great conversation especially around palliative care, patient experience, the real prevalence of COVID-19 and much more.
And if you want to contact Alex about caregiving, here is her Youtube Channel or please email her. — Matthew Holt
Each week an episode of “The THCB Gang” (this was Episode 3) is streamed live here (below) and is also preserved as a weekly podcast and available on our Itunes & Spotify channels a day or so later. Each week 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the shit about health care business, politics, practice, and tech. It tries to be fun but serious and informative!
This week, joining me were Deven McGraw (@healthprivacy), Kim Bellard (@kimbbellard), Vince Kuraitis (@VinceKuraitis), Michael Millenson (@MLMillenson), Brian Klepper (@bklepper1), Grace Cordovano (@gracecordovano) & Daniel O’Neill (@dp_oneill). It was an argumentative discussion about the developments around COVID19 and what we should pay attention to next week — Matthew Holt
By THOMAS WILSON PhD, DrPH and VINCE KURAITIS JD, MBA
A recent study in the New England Journal of Medicine reported on the results of a “hotspotting” program created by the Camden Coalition of Healthcare Providers (Camden Coalition). Hotspotting targets interventions at all or a subset of healthcare superutilizers – the 5% of patients that account for 50% of annual healthcare spending.
The results
of the study were disappointing. While utilization (hospital readmissions)
declined for the hotspotting group, the declines were almost identical in the
control group. At least three headlines
implied that the conclusion of the study was that hotspotting care management
approaches have been proven not to work:
“’Hot spotting’ doesn’t work. So what does?” Politico Pulse
“Reduce Health Costs By Nurturing The Sickest? A Much-Touted Idea Disappoints.” NPR
As we’ll
explain, we believe that much of what’s going on here can be explained by one
or both of what we call “RTM Traps” (regression to the mean traps).
In this
essay, we will:
Define RTM (regression to the mean)
Explain the RTM Traps and how many
have fallen into the traps
Suggest how to avoid the RTM Traps
We believe
our POV is relevant to clinical, technical, and executive staff in the many
organizations focusing on the superutilizer population – hospitals, physicians,
ACOs, health plans, community groups, etc.
This piece is part of the series “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?” which explores whether it’s possible to advance interoperability while maintaining privacy. Check out other pieces in the series here.
Early in 2019 the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare and Medicaid Services (CMS) proposed rules intended to achieve “interoperability” of health information.
Among other things, these proposed rules would put more data in the hands of patients – in most cases, acting through apps or other online platforms or services the patients hire to collect and manage data on their behalf. Apps engaged by patients are not likely covered by federal privacy and security protections under the Health Insurance Portability and Accountability Act (HIPAA) — consequently, some have called on policymakers to extend HIPAA to cover these apps, a step that would require action from Congress.
In this post we point
out why extending HIPAA is not a viable solution and would potentially
undermine the purpose of enhancing patients’ ability to access their data more
seamlessly: to give them agency over
health information, thereby empowering them to use it and share it to meet
their needs.
Which is better: sharing access to all health data across platforms so that interoperability is achieved, or protecting some data for the sake of privacy? Health data privacy experts Vince Kuraitis, founder of Better Health Technologies, and Deven McGraw, Chief Regulatory Officer at Ciitzen, are crowdsourcing opinions and insights on what they are calling The Health Data Goldilocks Dilemma. How much data protection is ‘juuuust right’? What should be regulated? And, by whom? The duo talks through their views on the data protection conversation and urge others to join in the conversation via their blog series called, “The Health Data Goldilocks Dilemma,” on The Health Care Blog.
Filmed at the HIMSS Health 2.0 Conference in Santa Clara, CA in September 2019.
