Category Archives: Uncategorized

“When you don’t create things, you beco

“When you don’t create things, you become defined by your tastes rather than ability. your tastes only narrow & exclude people. So create.” – From a ruby dude

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http://ow.ly/i/u4D3 Milliman Health Care

http://ow.ly/i/u4D3 Milliman Health Care Costs Index going through the roof. Last time I saw curve like that it was Facebooks user growth

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The Crossover Blog has Moved

The crossover blog is now integrated with our website www.crossoverhealth.com. Visit our new blog location by clicking here and keep following us for updates.

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Emerging from the Radio Silence

Peeps – sorry for the radio silence. Will make it up to you with this: http://ht.ly/4EMV8

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NJ ACO: A Sheep in PHYCORE Clothing

I am on an email list of Bill DeMarco’s, a reputable industry insider who has written and consulted extensively in the physician group and medical management space. He recently sent me a note about several physician aggregation events in New Jersey.

For some reason it struck a nerve with me . . . which led me to fire off the response below:

Bill,

I thought we already saw this movie?

My question for you . . . besides banding together in some megagroup – what are these physicians doing to actual change the delivery of medicine? ACO is just the latest buzzword excuse to aggregate physicians under a new moniker and a supposed new model.

I am highly suspect that these physicians are doing anything to change the relationship with their patients, to use enabling technology to create team based care, or actually be accountable for the outcomes they produce. What systems are they using to tie themselves together? What financial alignment do they have? What measures are they using to demonstrate superior outcomes? What about the patient experience – 7 minute visits that push pills as the “treatment” won’t get it done in the future.

I think your closing statement, “Representatives from Summit and Optimus were unavailable for comment” says it all.

Am I seeing this the wrong way? Is there anything new about this model this time around? Am I getting old enough to see these things cycle through?

PS – and no, I don’t mean a wolf. The sheep get nervous and band together waiting to get pounced on by wolves.

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Unsustainable: Worth a Thousand Words

I don’t even think there is anything to say about this picture:

This is why our health care system as current constructed is a massive #FAIL. Obamacare does NOTHING to change this.

 

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Crossover Piquant: Check this out!

Piquant (pē-känt’) adj.

  1. Appealingly provocative
  2. Charming, interesting, or attractive

One of the great promises of technology is to make things simpler, easier, and more affordable for end users. In the medical practice, we have so much complexity, difficulty, and cost in most of our processes that when we find something that actually works as advertised we fall in love.

I had one such “appealingly provocative” experience this weekend. While attending a high school football game in support of one of my member patients (leading passer in Orange County by the way!), the player was injured. I initially thought it was a concussive injury but the reason he remained down was the he knew he had severely rolled his ankle. His father called me from the field (I was in the stands) and I followed along by text messaging as he was treated initially by the trainer and later by the team orthopedic surgeon. He was unable to continue playing due to the injury and it was iced and wrapped overnight.

The next morning I met him at our clinic, fired up our new TRX GP-5 machine (all digital x-ray machine), and took some beautiful images. These were captured on our PC based OmniView rendering software (proprietary and expensive) and fed to our OsiriX viewing software (open source and free!). I was able to manipulate the image at will, contrast and enlarge as needed to highlight all the structures, and automatically send the image to a remote radiologist for reading. No films to carry, no chemicals to purchase, and no storage required – ever. Simple, Efficient, and Affordable.

But I was just warming up.

The process we are using at Crossover Health to acquire an x-ray image to the iPad

The piquant was my ability to wirelessly transmit the image from my MacBook (serving as a server) to the iPad. This process is made possible by the fact that I have can move the standards based DICOM image from a PC to a MAC (using OsiriX), and then push it out to my iPad. While I thoroughly enjoy technology, I often get frustrated because I lack the technical expertise and patients to work out all the kinks. I was pleased to see that I was able to point and direct all the connections where they needed to go and the images appeared neatly onto my iPad without any problems.

From the patient experience, all they knew was that the image was shot, its being read by a board certified radiologist, and they are seeing, touching, and experience the iPad as a new device in our patient-physician relationship.  The patient was intrigued, impressed, and engaged (entertained?) by the whole process. I dare say it was a “fun” visit (why does the typical health care experience have to be so lame anyway?) for them to participate in this process, see their physician pushing the technology barriers, and engaging in the diagnostic process in a way they never have before.

The piquant experience certainly piqued the interest of their family who had the family.

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