DOD, VA stuck behind the Magic 8 Ball: report (US)

Institute of Medicine, ‘Daily Show’ rap DOD, VA for unlinked EHRs

When the US Department of Defense (DOD) and Veterans Affairs (VA) announced back on 27 February that they would not achieve their major goal since 2009 of a single EHR system by 2017, with initial test next year, for this Editor it was just another billion-dollar ‘fail’ day out of DC. FDA dithers since July 2011 on final guidance on mHealth approval–yawn. Centers for Medicare and Medicare Services (CMS) cutting back rural telemedicine consults–business as usual. Individual health insurance premiums going up 30 percent next year? We knew that was coming! So no surprise here when the Institute for Medicine of the National Academy of Sciences issued a report highly critical of both agencies regarding the needs of 2.2 million Iraq and Afghanistan veterans, with one key criticism the lack of EHR interoperability. According to iHealthBeat:

The IOM report found that:
• 49% of returning veterans have experienced post-traumatic stress;
• 48% have dealt with the “strains on family life;”
• 44% have experienced readjustment difficulties; and
• 32% have felt “an occasional loss of interest in daily activities.”
According to IOM, the federal government’s response to troops returning to the U.S. “has been slow and has not matched the magnitude of this population’s requirements as many cope with a complex set of health, economic and other challenges.”

Neil Versel in his Meaningful HIT News article published yesterday highlighted the EHR single-system fail through, rather incredibly, a Jon Stewart Daily Show video segment called ‘Red, White and Screwed’. (Today, in American life, you know an issue has gone mainstream when it makes a ‘news/comedy’ show such as this or the Colbert Report.) This Editor is no fan for multiple reasons, but to his credit Mr. Stewart has been a strong advocate on behalf of veterans and showcases the failure of veterans’ support regularly on a segment called ‘The Red Tape Diaries’ without sparing a certain Administration from criticism.  Aside from over 900,000 veterans waiting an average of 273 days for their disability claims to be processed, the icing on the cake is how the EHR ‘fail’ was announced. At 3:20 in the video, a Government Accountability Office (GAO) official drily depicts both DOD and VA as perpetrators of project mismanagement and poor oversight. And this is despite a 40 percent increase in budget from the Republican-controlled House, which confounded Mr. Stewart. The criticism goes on from there. Magic 8 Ball says ‘messed up, try again.’  DoD-VA integration failure is no laughing matter, even to Stewart  Hat tip to reader Ellen Fink-Samnick, MSW of ‘Ellen’s Ethical Lens’ for featuring this article on her LinkedIn group. 

Related, ironic note: the DOD’s and VA’s EHRs are respectively called AHLTA and VistA, a nostalgic touch for those of us who used the first real search engine, AltaVista, circa 1996.

Health tech grows…but where are the investors?

Health tech, digital health, wireless health, telehealth, eHealth, mHealth, connected health…while the terminology proliferates, the hype curve grows ever steeper and the conferences/cocktail parties ever buzzier, where is the investment? David Doherty’s identified 16 billionaires investing in health tech, but David Shaywitz writing in Forbes, who’s been up and down the biotech curve, is noting that VCs who should be gravitating to digital health, aren’t.  This is even though they have the most experience scouting the territory: the medical problems to be solved, the stakeholders, the development curve. This isn’t to say that some are actively investing and others are observing the waters–he cites PureTech Ventures, Venrock, Fidelity Biosciences as the former–but when he cites a principal of a major biotech VC openly tweeting a withering view of most ‘digiHC’ (another term!) as without a real business model, ‘more sizzle than steak’ and ‘merely a bubble’ equivalent to (US) cleantech….it’s ‘perception is reality’ time. So before mHealth starts connecting to genomes, some successful exits need to go on the scoreboard first. Life Science VCs: Definitively Indefinite About Digital Health

Perhaps too much of consumer directed health tech focuses on how novel it all is–which can sell in the short term–with an emphasis on low-cost apps and Quantified Self trackers. But neither right now, with a few exceptions, have the push from the physician–and their advocacy requires multiple steps to achieve: awareness, trial, validation and support. Also from ForbesDigital Health Strategy: From Novelty to Necessity. An overview of how this can work for apps is what Happtique has accomplished to date in establishing standards, a certification program and a platform to facilitate physicians in prescribing apps and backing them up with patient educational materials. App Prescribing: The Future of Patient-Centered Care (Health Care Blog)