Tag: Kim Bellard

There Will Be Consequences

Apr 14, 2020• 1

By KIM BELLARD

Crises — like our current COVID-19 pandemic — force people to come up with new solutions. They slash red tape, they improvise, they innovate, they collaborate, they cut corners. Some of these will prove inspired, others will only be temporary, and a few will turn out to be misguided. We may not know which is which except in hindsight.

I covered some of these in a previous article, but let me highlight a few:

Hospitals: We’re building new hospitals, such as in convention centers, to address the expected shortage of beds. Hospitals are also coordinating where to send which types of patients.
Testing: We’re creating drive-through testing centers in parking lots and elsewhere.
Telehealth: We’ve loosened the restrictions on telehealth, improving reimbursement and rules about when it can be used.
Coverage: We’re trying to ensure that deductibles/copayments do not pose barriers to people getting tests and treatment, even for those without insurance.
Clinicians: We’re looking for clinicians everywhere we can — allowing licensed ones from other states to practice, letting people who were health care professionals in other countries practice here, calling retired ones back into service even if their license had expired, even letting almost-graduated medical professionals start practicing.
FDA approvals: The FDA is using its “emergency use guidance” authorization to start allowing use of drugs and other treatments much quicker, and with much less evidence, such as for hydroxychloroquine, diagnostic testing, and ventilators.

The THCB Gang Episode 3, (LIVE Today at 1PM PT/4PM ET)

Apr 2, 2020

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

Pandemics Are the Mother of Invention

Mar 31, 2020

By KIM BELLARD

If, as they say, necessity is the mother of invention, then you’d have to say that the COVID-19 pandemic is proving to be the mother of invention and innovation. And, like Isaac Hayes sang about Shaft, it is a “bad mother…(shut your mouth).”

Many believe that the Allies won WWII in large part because of how industry in the U.S. geared up to produce fantastic amounts of weapons and other war materials. It took some time for businesses to retool and get production lines flowing, during which the Axis powers made frightening advances, but once they did it was only a matter of time until the Allies would prevail.

Similarly, COVID-19 is making scary inroads around the world, while businesses are still gearing up to produce the number of ventilators, personal protective equipment (PPE), tests, and other badly needed supplies. COVID-19 is currently outnumbering these efforts, but eventually we’ll get the necessary equipment in the needed amounts.

Eventually.

A Healthcare System, If We Can Keep It

Mar 18, 2020

By KIM BELLARD

We are in strange days, and they are only going to get stranger as COVID-19 works its way further through our society. It makes me think of Benjamin Franklin’s response when asked what kind of nation the U.S. was going to be: “A Republic, if you can keep it.”

The versions of that response that COVID-19 have me wondering about are: “A federal system, if we can keep it,” and, more specifically, “a healthcare system, if we can keep it.” I’ll talk about each of those in the context of the pandemic.

In times of national emergencies — think 9/11, think World Wars — we usually look to the federal government to lead. The COVID-19 pandemic has been declared a national emergency, but we’re still looking for strong federal leadership. We have the Centers for Disease Control, infectious disease experts like Dr. Anthony Fauci, and a White House coronavirus task force. But real national leadership is lacking.

Still Fighting the Wrong Wars

Mar 4, 2020• 1

By KIM BELLARD

What do the coronavirus and Navy ships have in common? For that matter, what do our military spending and our healthcare spending have in common? More than you might think, and it boils down to this: we spend too much for too little, in large part because we tend to always be fighting the wrong wars.

I started thinking about this a couple weeks ago due to a WSJ article about the U.S. Navy’s “aging and fragmented technology.” An internal Navy strategy memo warned that the Navy is “under cyber siege” by foreign adversaries, leaking information “like a sieve.” It grimly pointed out:

Our adversaries gain an advantage in cyberspace through guerrilla tactics within our defensive perimeters. Once inside, malign actors steal, destroy and/or modify critical data and information.

This is the Navy, after all, that proudly tried to modernize by installing touch screen technology on some of its ships, only to have the disaster that hit the USS McClain. Its vaunted Integrated Bridge and Navigation System was, ProPublica found, “was a welter of buttons, gauges and software that, poorly understood and not surprisingly misused, helped guide 10 sailors to their deaths.” And that wasn’t the only technology-enabled naval disaster in recent years.

Time Really Can Be Money

Feb 27, 2020• 1

By KIM BELLARD

If you are not an IKEA fan, or haven’t been spending any time in Dubai, you may have missed the chain’s marketing campaign to help promote its second store in the area. Titled “Buy With Your Time,” customers got store credits for how long they spent getting to the store.

Gosh, that’s something that should make any self-respecting critic of the U.S. healthcare system perk up. Count me as intrigued.

The campaign involved checking the customer’s Google Maps’ Trip tab to determine how long it took them to get to the store. IKEA benchmarked the average hourly wage in Dubai, and converted the travel time into how much credit they’d generated. It works out to about $29/hour, or $0.48 per minute. Spend long enough getting there and you could get a free coffee table or even a bookcase. Prices in the store include the equivalent time currency.

Who’s in Your Supply Chain?

Feb 21, 2020

By KIM BELLARD

Tesla is now, by market cap, the second largest auto manufacturer (after Toyota). Its market cap exceeds U.S. auto makers Ford, G.M., and Fiat/Chrysler — combined. This despite selling less than 400,000 vehicles in 2019, a figure that is more than the prior two years combined.

Tesla has made its bet on the future of electric cars. It didn’t invent them. It isn’t the only auto manufacturer selling them. But, as The Wall Street Journal recently said:

Investors increasingly see the future of the car as electric—even if most car buyers haven’t yet. And lately, those investors are placing bets on Tesla Inc. to bring about that future versus auto makers with deeper pockets and generations of experience.

A recent analysis suggested a big reason why, and its findings should give those in healthcare some pause. Tesla’s advantage may come, in large part, from its supply chain.

Healthcare Has a Moral Injury

Feb 13, 2020• 1

By KIM BELLARD

The term “moral injury” is a term originally applied to soldiers as a way to help explain PTSD and, more recently, to physicians as a way to help explain physician burnout. The concept is that moral injury is what can happen to people when “perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.”

I think healthcare generally has a bad case of moral injury.

How else can we explain physicians practicing surprise billing, hospitals suing patients, health plans refusing to pay for pre-authorized treatments, or pharmaceutical companies charging “skyrocketing” costs even for common, essential prescription drugs? There are people involved in each of these, and countless more examples. If those people haven’t suffered a moral injury as a result, it’s hard to understand why.

Melissa Bailey, writing for Kaiser Health News, looked at moral injury from the standpoint of emergency room physicians. One physician decried how “the real priority is speed and money and not our patients’ care.” Another made a broader charge: “The health system is not set up to help patients. It’s set up to make money.” He urged that physicians seek to understand “how decisions made at the systems level impact how we care about patients” — so they can “stand up for what’s right.”

For Your Eyeballs Only

Feb 7, 2020

By KIM BELLARD

There’s so much going on. There’s the coronavirus: It’s now a pandemic! China can build an entire hospital to treat coronavirus patients in under two weeks! Or there’s primary care: One Medical’s IPO boomed! Amazon, Humana and Walmart are testing their versions! People are flocking away from primary care! Or, on a completely unrelated note, Tesla wants to disrupt auto insurance too.

As interesting as all those are, it’s augmented reality (AR) that I want to talk about.

Stop thinking about Snap Spectacles or Pokémon Go as what you think of when you think about AR. Stop thinking about the supposed failure of Google Glass. Start thinking about AR being ingrained in our daily lives.

Facebook CEO Mark Zuckerberg believes “at some point in the 2020s, we will get breakthrough augmented reality glasses that will redefine our relationship with technology.” He went on to elaborate:

Instead of having devices that take us away from the people around us, the next platform will help us be more present with each other and will help the technology get out of the way. Even though some of the early devices seem clunky, I think these will be the most human and social technology platforms anyone has built yet.