Coordinated Health Care & Evidence Based Medicine, Aided by Social Media

Slate Magazine analyzed the Obama administration’s forecasted $2 trillion in health care savings, then questioned which initiatives would provide true savings.  The highest ranked initiatives were encouraging coordinated care… and …adherence to evidence-based best practices and therapies… Coordinated care suggests clinical integration and savings derived from better information—about what works and what doesn’t work—creates efficiencies.  

Increased information could increase the benefits of innovation and the ability for federated groups of health plans to use the best ideas for the best results.  Secure Social Media, i.e. the idea of aiding discovery within the enterprise can help.   No World Borders has been advising health care firms on ways to use social media techniques to provide openness, while still providing security and privileges regarding who can access the information within the enterprise.

From Slate:

  1. Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies.
  2. Coordinated care seems to suggest integration of clinical care by hospitals and doctors. If bundling requires doctors and hospitals to knock heads over submitting a single bill, integration requires doctors and hospitals to knock heads over how the patient will be cared for. “You have to grow both organically side by side,” Reinhardt says. A good start, he added, would be getting the pediatrician, obstetrician, and gynecologist to develop a common plan for an individual childbirth; medical procedures don’t come much more straightforward than the delivery of babies. “Evidence-based best practices and therapies” refers to compiling national statistics about which clinical approaches work best and then putting some pressure on physicians and hospitals to follow them. It’s very difficult to know in advance what the budgetary impact of this information would be. In a recent article in the Annals of Internal Medicine, Theodore Marmor, Jonathan Oberlander, and Joseph White wrote, Although comparative effectiveness research may provide useful information about the clinical effectiveness and costs of medical treatment options, that information is not guaranteed to lead to significant cost savings. The Congressional Budget Office calculates that between the new money spent on research and the savings derived from better information about what works and what doesn’t, the net five-year cost to the federal government would be $490 million over five years. Total health care spending—public and private—the CBO says, would be reduced by $8 billion over 10 years. The CBO doesn’t have a five-year number, so we’ll slice that one in half.
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Michael F. Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. His vision for the firm is to continue acquisition of skills and technology that support the intersection of clinical data and administrative health data where the eligibility for medically necessary care is determined. He leads a team that provides litigation consulting as well as advisory regarding medical coding, medical billing, medical bill review and HIPAA Privacy and Security best practices for healthcare clients, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, physician compensation, Insurance bad faith, payor-provider disputes, ERISA plan-third-party administrator disputes, third-party liability, and the Medicare Secondary Payer Act (MSPA) MMSEA Section 111 reporting. He uses these skills in disputes regarding the valuation of pharmaceuticals and drug costs and in the review and audit of pain management and opioid prescribers under state Standards and the Controlled Substances Act. He consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises ERISA self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, studies at Harvard Medical School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims). Mr. Arrigo has been interviewed quoted in the Wall Street Journal, New York Times, and National Public Radio, Fortune, KNX 1070 Radio, Kaiser Health News, NBC Television News, The Capitol Forum and other media outlets. See https://www.noworldborders.com/news/ and https://www.noworldborders.com/clients/ for more about the company.