After my Monday morning panel at Partners Health Care’s Connected Care Symposium conference, I attended a few others. The PHR panel involved the three major ePHR vendors, Microsoft, Google, Dossia, and the fourth was the health information Web giant WebMD. The exchange between Grad Conn from HealthVault (the Microsoft initiative) and Jerry Lin, product manager of Google Health, was quite amusing when the moderator pushed for an answer to whether the two companies will allow users to switch between the two platforms easily and conveniently. Grad responded diplomatically by saying that Microsoft is ready to do so if Google allows. Jerry shot back by saying “Google is ready too.” Shall we expect some announcement soon? Perhaps not a chance. The two companies currently have no incentive or business reasons to pursue such collaboration.

Grad was once again under the spotlight when the operator asked him why HealthVault had not joined the Continua Alliance. Searching for a more diplomatic answer (which he did gracefully), Grad cited no Continua-certified devices on the market as a major reason that Microsoft so far has not considered Continua membership. My take is that Microsoft sees HealthVault as more application-driven and Continua as more device-driven. This difference has caused Microsoft’s wait-and-see attitude towards Continua.

A Tuesday afternoon panel on CMS reimbursement policy also provided good information. Joe Ternullo from Partners highlighted four paths to reimbursement for home health monitoring devices. The panel, consisting of Joseph Kvedar, the Director of the Center for Connected Care, Pat Gardner, Senior Reimbursement Manager from Medtronic, and Robert Mechanic, Senior Fellow and Director from Health Industry Forum and a Professor at Brandeis University, was asked to rate the probability and feasibility of the four financing models. The four pathways include:

-Direct reimbursement of home health monitoring technology
-Post-acute care payment system
-Reimbursement through the Medical Home model
-Reimbursement through the case management model

All agreed that direct reimbursement from Medicare is “dead on birth” as the agency is expected to cut budget across the board and such big-ticket reimbursement item is unlikely to pass the muster of the agency’s cost control goal. They also expressed doubt about the Medical Home model as recently published Medicare demonstration project guidelines showed that payment difference between certified tier-one medical home practices (which does not require IT investment) and tier-two practices (which require various degrees of IT integration) is only $10-12 ($40 vs. $52), which does not provide much incentive for physicians to invest in technologies. They have slight different views on the other two. I asked DR. Joseph Kvedar privately after the panel which one he favors. He said that the case management model is the one that Partners HealthCare is working on.

Overall the Symposium is a nicely packaged two-day event covering many areas that the Connected Care model is going to address. High-caliber speakers and well-rounded discussions make it a good experience overall.