February 2012

[Commentary] Every week as we consider our round up we weigh delving into the week’s biggest story or shedding light on articles that may have flown below the radar. This week is no different. The biggest story of the week, by far, is Facebook taking its first step toward becoming a publicly traded company as it filed to sell shares on the stock market. In addition, there were big developments in privacy, ensuring low income Americans have affordable access to telecommunications, and spectrum policy.

You say TV, I say Internet. Toe-mate-o, toe-maht-o. Technology increasingly blurs the lines between computer, television, phone and tablet. Online video options grow almost by the hour. A screen, in the era of cyber choice, is a screen is a screen. You can now plug the Internet straight into the newest TVs. You can buy gadgets that will bring the Web to your old set. Or you can use your phone, tablet or other electronic gizmos to tap into the Internet to give you TV on the go. Still, to fill your screen with popular sports, comedies and dramas from the brands that dominate your television, generations-old economic models will have to be rearranged for the wild, wild Web. Some entrepreneurs are toying with new models that tap into an Internet specialty — the ability to tailor choices to the individual viewer — that might give advertisers a better platform on the Internet than they have in one-size-fits-all cable TV audiences. But true Internet TV is facing a big obstacle: It’s the old-school cable and cable-like services, after all, that have got the makers of programming locked up in mega-contracts.

It’s a little stunning to contemplate how wrong things have gone for Google in just the first month of 2012, as the company hopes to put a disastrous January in the rear-view mirror with perhaps another tear-jerking Super Bowl ad this Sunday.

Larry Page and Sergey Brin haven’t turned into Jim Balsillie and Mike Lazaridis or anything, but Google just endured the worst month in the company’s history and nothing will get easier as rivals and the government take aim at what used to be such a delightful fuzzy little tech success story. Google’s unlikely to have a month like that again, this year anyway. But it’s kind of shocking to contemplate just how uneasy the company has made a lot of people by its decisions around social search and privacy. Perhaps more troubling, its responses to those big questions have been tone-deaf and almost defiant, traits one did not associate with Google until recently.

Across the country, health care providers are making significant investments to redesign care processes and strengthen their health information technology (health IT) capabilities with the goal of achieving better care, better health, and lower costs. For the American health care system as a whole, the simultaneous pursuit of all three of these aims is essential to sustaining any one of them. Over the years, economists and health IT experts have projected a wide range of cost savings from health IT implementation. These kinds of analyses are challenging because they require experts to predict how health IT will influence changes in provider and consumer behavior, and how those changes in behavior in turn influence quality and financial outcomes. Yet it is still important to understand how health IT can support the nation’s efforts to “bend the cost curve” and ultimately slow the growth of health care spending, while improving outcomes and the health of the population. Within this context, a single health care health IT-enabled intervention that achieves the goal of improving health care quality may be more likely to spread if that intervention has also demonstrated measurable net reductions in health care expenditures.