Kim Bellard

So many counter-intuitive findings recently.  For example, a new study claims 7 of the 10 most profitable hospitals in the country are "non-profit."  Let me say that again, most profitable hospitals in the country are usually nonprofit.  Or, despite the drive to improve surgical quality by limiting surgeries at low volume hospitals, it appears that the relationship between volume and patient outcomes is not as clear as had been thought, once "more advanced statistical modeling" is used to analyze the data.  Wait, what? Either one of these would be a good topic to write about, and many others have done so already (e.g., KHN and Modern Healthcare, respectively)...

People love to talk about "moonshots" in health (e.g., Joe Biden, GE).  I'm not exactly sure why that is a good goal.  The actual moonshot took thousands of people many years and tens of billions, all to send a few people far away for a short period and never again.  It may or may not have produced otherwise useful technological advances (Tang, anyone?).  Sounds a lot like health care now, actually. I suggest a different goal: let's make health care "Five by Five." Five by five is a communications term to quantify the signal-to-noise ratio.  It means the best possible readability with the best possible signal strength.  I.e., the signal is loud and clear.  By contrast, "one by one" would essentially mean "I can't figure out what you're telling me but that's OK, because I can't really hear you"...

Bad news: if you were still hoping to get one of the $400 juicers from Juicero, you may be out of luck.  Juicero announced that they were suspending sales while they seek an acquirer.  They'd already dropped the juicer's price from its initial $700 earlier this year and had hoped to find ways to drop it further, but ran out of time. I keep thinking: if they'd been a health care company, they not only might still be in business but also would probably be looking to raise their prices. Juicero once was the darling of investors. It raised $120 million from a variety of respected funding sources, including Kleiner Perkins, Alphabet and Campbell Soup. They weren't a juice company, or even an appliance company. They were a technology company! They had an Internet-of-Things product! They had an ongoing base of customers...

Alan Kay recently outlined some of the principles that he thought made Xerox's PARC so successful (if you don't know who Alan Kay is or why PARC was so special, you should try to find out).  One was: "'It's baseball,' not 'golf'...Not getting a hit is not failure but the overhead for getting hits." That doesn't quite square with my impression of golf, but I take the point.  It's about the price of success. As psychologist Dean Simonton pointed out in Origins of Genius: "The more successes there are, the more failures there are as well."  "Quality," he wrote, "is a probabilistic function of quantity." We talk a lot about innovation these days, especially "disruptive innovation."  Why not?  It sounds cool, it allows people to think they're on the cutting edge, and it often excites investors.  But perhaps we've lost sight of what it is supposed to actually be...

Politico (Dan Diamond) had two great pieces last week -- one on how tax-exempt hospitals benefited from the Affordable Care Act (ACA) while cutting charity care, and the second on how the Cleveland Clinic has built an island of prosperity amidst an impoverished community.  I'd like to say I'm surprised, but I'm not.  I wrote about the supposed community benefits of "non-profit" hospitals two years ago, and Politico's analysis suggests things are getting worse. They looked at the top seven hospitals, as ranked by U.S. News & World Report, and found...

About a year and a half ago I wrote I Hate Apps, expressing my concerns that apps had outlived their usefulness due to how they are cluttering up our devices, and found I wasn't alone in this attitude.  Now Facebook is doing something about it, with their vision that they can use "bots" within their Messenger app to eliminate the need for many standalone apps. Indeed, as David Marcus, the head of messaging at Facebook, told Wired: "Everyone wanted websites when the web was launched. And then everyone wanted apps.  This is the start of a new era"...