Different year, same dream, more hope.  Connected Health Symposium in Boston sponsored by Partners Health Care had more than 1000 attendees and an optimistic tone following this past year's congressional investments in health care reform pilot programs that may include the use of telehealth-type technologies. If you were a new attendee with a pesky chronic condition, perhaps you would have been alarmed at the continuing (from previous years) discussions about what to do about you: 'nudge' via incentives or penalties toward healthier behaviors, overcome your underwhelming (10%) nationwide sign-up for personal health records, devise new ways to 'amp up' your compliance with doctor-prescribed regimens, argue whether your favorite social networks will get you to do what the doctor can't -- and above all, get your active participation in harnessing the ballooning cost of care.  Lots of talk about payment reform from today's transactional and confounding fee for service to (deep breath): 'outcome-driven, quality-based, global payments through accountable care organizations.' I think that means charge less, pay less, get less of what today costs too much for too little in the way of results: