HealthCare COVERAGE FROM AROUND THE WEB
A new advisory panel has begun work to support the development of a regulatory framework to help ensure patient safety is maintained as the use of electronic health records, wireless medical devices and other health IT continues to expand.The new Food and Drug Administration Safety Innovation Act Workgroup will advise the HIT Policy Committee of the Office of the National Coordinator for Health IT. ONC is working with the Food and Drug Administration and Federal Communications Commission to develop recommendations for a "risk-based regulatory framework" for health IT. The goal of the framework is to balance innovation with patient safety and avoid regulatory duplication."We believe technology is a critical tool to transforming healthcare," ONC leader Farzad Mostashari, M.D. told workgroup members at the group's inaugural meeting April 29. But the overall benefits of health IT also must be weighed against "concerns for privacy and security, as well as safety," he says. The ONC, FDA, and FCC will consider the workgroup's recommendations as they collaborate on a report due to Congress by January 2014 on a risk-based regulatory framework that promotes innovation "while protecting patient safety," he adds. The Food and Drug Administration Safety Innovation Act mandated the report.In the coming weeks, the workgroup will work toward defining the kinds of risks to be addressed by the regulatory framework as well as the types of health IT involved with those risks.
Every year, the analyst firm Gartner publishes between 90 and 100 “Hype Cycles” with insight on about 1,900 different technologies. The Hype Cycle above is the one for Emerging Technologies for 2012 (published in August) and shows “Big Data” heading toward the “Peak of Inflated Expectations.”According to Gartner, Big Data has about 2-5 years before reaching it’s ”Plateau of Productivity.” That’s the enviable point at which a technology finally delivers predictable value. The promise of Big Data, of course, is a treasure trove of high value across many industries – including healthcare. Everything from predictive and prescriptive analytics to population health, disease management, drug discovery and personalized medicine (delivered with much greater precision and higher efficacy) to name but a few.Like many emerging technologies, the future here is brilliant and chock-full of headlines highlighting all the rich rewards ahead. In the meantime, however, ”little data” in healthcare continues to give us all peptic ulcers.While it lacks any formal definition, one way to think of little data is anything that operates at the unit level. One account, one patient, one customer, one transaction or one record. Healthcare billing data has evolved sufficiently that much of it has been standardized and automated – but clinical data is still years behind. Clinical data at the unit level is chaotic and dysfunctional because it’s not easily transferable or usable outside of the system that first created it. In a world of competing financial interests and an increasingly mobile population – every patient encounter represents an opportunity for technology vendors to lock-in providers.
Doctors prescribing phones apps to manage health problems
The Columbus Dispatch
Sunday March 31, 2013 7:32 AM
Dr. Jennifer Dyer and Duet Health are planning a clinical trial for their app to gauge its efficacy.
Doctors are beginning to prescribe smart-phone applications and medical devices they work with
to help patients manage chronic illnesses, including heart disease, diabetes and asthma.“I think this app revolution has one of the largest potentials to revolutionize health care and
can be a large paradigm shift in how we provide care,” said Albert Lai, a biomedical informatics
expert at Ohio State University.“We don’t need a specialized device if we can find a way to integrate this care into something
people already own.”Simple apps that help people with their fitness or remind them to take their pill prescriptions
already are widely popular. But new device applications are taking mobile health — or mHealth as
practitioners are calling it — to a new level.Take the IBGStar Blood Glucose System. It uses a glucose meter that plugs into smart phones.Or
the iHealth Blood Pressure Monitor, with a cuff that connects to the phone, and SmartHeart, which
works with a heart monitor harness that wirelessly transmits information to the phone.
You may not realize how difficult it is for enterprise systems to be able to move information between hospitals, private practices, and reference laboratories.
He is the chief science officer for the ONC (Office of the National Coordinator or Health Information Technology) at the Department of Health and Human Services.
During the interview he gives a simple definition of interoperability and how it can break down barriers in sharing health information.
Additionally, this information exchange can help reduce redundant records, improve speed of information retrieval, and make the entire process flow in an efficient manner.
Dr. Fridsma emphasizes that this process must take place with respect to patient's privacy and involvement.
He is optimistic on the adoption rate of EHR's - in fact, he estimates that by the end of 2013 there will be an 85 percent adoption rate for EHRs among physicians in the United States.
Other topics include the success of the Blue Button initiative, mobile devices, and Health Information Exchanges.
After twisting her ankle, Anne Taylor visited a Maryland health care clinic, where she was given a computer tablet and asked to fill out her medical history electronically. But Taylor could not perform the task. She is blind, and the tablet had no way of recording medical information without typing.“Obviously, I couldn't do it, so I had to get help from the clerk,” said Taylor, director of Access Technology for the National Federation of the Blind in Maryland. “In a sense, I was giving my personal data to essentially a stranger. I didn't have any choice. I wanted to get my injury looked at.”Such an experience is becoming more common for impaired patients as more medical practices move to electronic health records and electronic resources. Too often, health professionals do not consider whether disabled patients or employees are able to use electronic equipment such as EHRs, public websites and e-tools until a problem arises, legal experts say.Recent legal challenges and settlements related to violations of the Americans with Disabilities Act highlight the problem of noncompliant e-data. In January, the 8th U.S. Circuit Court of Appeals found Creighton University School of Medicine in Nebraska liable for not providing reasonable software accommodations to a student with a hearing impairment. The medical school said it already had provided adequate education alternatives to the student.
IBM’s Dr. Watson of Jeopardy! fame has finally completed its residency and fellowships and, presumably to its creators’ utter delight, is now a practicing oncologist.The prodigy “cognitive system” completed its training in less than a year at the illustrious Memorial Sloan-Kettering Cancer Center, and although only proficient in lung cancer right now, Dr. Watson’s career as an advisor to oncologists everywhere is off to a great start.A recently released video demonstration shows Dr. Watson in action, researching, evaluating and treating a 37 year old woman with newly diagnosed stage IV lung cancer in his advisory capacity to a hurried and pretty uninspiring human oncologist. Regardless of the slightly weird scenario, it is worth noting that in a fraction of a second Dr. Watson, scours 3,469 text books, 69 guidelines, 247,460 journal articles 106,054 other clinical documents and 61,540 clinical trials, and evaluates their contents against the patient’s EMR to identify need for further diagnostic tests and treatment options for this patient. Being an exceedingly helpful advisor, Dr. Watson quickly reads the entire EMR and uses his trained processing power to eliminate all the clutter in the EMR, presenting to the human doctor only information pertinent to this particular diagnosis. Ouch.
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In the run-up to and in the wake of last week’s congressional hearings on potential Food and Drug Adminstration regulation of mobile health and medical apps, we have heard numerous alternatives to the existing FDA regulatory framework proposed.Congress should give the Office of the National Coordinator for Health Information Technology (ONC) the power to regulate not only apps, but also electronic health records, some have suggested. Others would like to see self-policing by the private sector, akin to the initial role of the Certification Commission for Healthcare Information Technology (CCHIT), which started as the EHR vendors’ answer to the prospect of regulation. Happtique may seem to be heading down this path, but CEO Benjamin Chodor shot that notion down during the hearings.A third approach might be along the lines of what CCHIT has become today, a participant in a privately run but federally monitored certification program to test products against government standards.And then there is the interesting idea proffered by Dr. Thomas Santo on the popular KevinMD blog last week: Get physician organizations involved.“If you visit the websites of some of the major medical organizations in the country, the American Medical Association, the American College of Physicians, the American Academy of Pediatrics, among many others, not one of them has a link to ‘endorsed apps,’ ‘mobile health’ or any other reference to digital health tools,” Santo wrote. I don’t know who the “many others” are, so I can’t check this claim, but the point is taken.
I’m a geek and you know how much I support the inclusion of digital technologies in medicine, healthcare and medical education. At the same time, I always highlight the fact that doctors will be needed for practicing medicine, robots cannot do their job. I know Vinod Khosla thinks otherwise.Now, after watching the video demonstration of how Watson could help a clinician, I have doubts about a future. We will see how it gets integrated in everyday medicine. I support the IBM Watson project very much, but I hope medical professionals, humans, will always play the major role in the practice of medicine.
Washington The mandated transition by billers throughout the health system to the more complex ICD-10 diagnosis codes will go forward without any further delays, the Centers for Medicare & Medicaid Services stated in a Feb. 6 letter to the American Medical Association.Acting CMS Administrator Marilyn Tavenner made the case for moving forward with ICD-10 to modernize the health care system. Halting its implementation, which has been ongoing since 2009, would mean relying on outdated ICD-9 codes that soon will be incompatible with general health care needs and new technologies, she stated.Many in the health industry are under way with the necessary system changes to transition from ICD-9 to ICD-10, Tavenner wrote. Halting this progress midstream would be costly, burdensome, and would eliminate the impending benefits of these investments. Many private and public sector health plans, hospitals and hospital systems, and large physician practices are far along in their ICD-10 implementation and have devoted significant funds, resources and staff to the effort.In December 2012, the AMA and about 80 other organized medicine groups had requested that CMS stop ICD-10 implementation. The AMA House of Delegates had approved official policy to advocate for abandoning ICD-10. Costs related to training and infrastructure upgrades could be enough to force physicians out of business, the organizations said.
The British Columbia Medical Association and other experts are calling for the Canadian government to crack down on pharmaceutical companies that are marketing their products directly to consumers through social media websites, the Vancouver Sun reports. Canadian law prohibits pharmaceutical companies from marketing drugs directly to consumers. Drug advertisements in the country are allowed to mention only a drug's name, price and quantity. However, international drug companies are circumventing Canadian law by using the Internet to push ads directly to consumers.
According to a study published in the Journal of Medical Internet Research, the top global pharmaceutical companies have a presence on: The study also found that most drug companies have a presence on YouTube, mobile applications and Pinterest.In response to the growing prevalence of drug ads on social media sites, BCMA has proposed a policy calling for health officials to appoint a watchdog group to block such ads in Canada. Jonathan Agnew -- the BCMA policy analyst who drafted the policy -- said that the ads often contain misleading information and could encourage patients to ask for medication they do not need. According to Agnew, health care spending could increase if physicians feel pressured to provide brand name drugs.
These days you can get a text alert to remind you of most anything. Your bank sends you an alert when your account is running low, and your airline emails to let you know your upcoming flight has been revised. You can set a reminder to get your car's oil changed, so why can't your doctor's office send you an email or tweet to help you manage your healthcare?We know you're online looking for medical info anyway. The Pew Internet & American Life Project's “Health Online 2013” survey found roughly 70-75% of Internet users aged 18-64 search online for health information, as do 58% of Internet users aged 65 and over. Doctors are feeling the pressure to do more online, too. “As more patients are receptive to the digital world, we doctors want to engage them more where they are…online,” Dr. Jason Cunningham, Medical Director at West County Health Centers in California tells Mashable. But there’s one big, important elephant in the room blocking the digital stampede of online access to your doctor and your healthcare and that’s HIPAA (Health Insurance Portability and Accountability Act of 1996). The privacy rule protects your personally identifiable health information and sets national electronic security standards for your protected health information. And that’s a good thing.
Lawmakers, doctors and journalists send out tweets by the millions on health care and health reform — but the three groups don’t have the same take on Twitter, according to a new analysis.Botox comes up a lot more among doctors. Pfizer and Merck pop up among a sampling of health journalists. And Medicare dominates lawmakers’ health tweets — occurring more frequently than unemployment, abortion or even Obamacare. Medicaid expansion also scored big in recent months.“Medicare is a hugely political subject. I think every congressman was using every outlet they had,” said Greg Matthews with the communications firm WCG, which analyzed about 2.5 million health tweets for Kaiser Permanente.The study will be made public Tuesday, and an advance copy was given to POLITICO. Kaiser Permanente said it was interested in tracking patterns and also looking at how some topics it was particularly interested in — like low-cost interventions to prevent disease including sunscreen or hand washing — were showing up on Twitter.The bottom line: Overall, physicians prioritized health education, the media paid a lot of attention to the business end of health care and lawmakers had their thumbs on the politics.The analysis focuses mostly on 2012 but contains some data going back to the start of the health reform debate in 2009. It looked at how the three groups tweeted about national health policy and how they addressed big health threats to the U.S. population such as obesity and cancer.
There are an estimated 15,000 medical apps presently on the market and is expected to grow 25% per year according to one study. There are issues which are common in the development of these apps and other categories of apps. However, some technical and non-technical issues are unique to the sector. As someone who does not design apps, I will offer a perspective which covers topics raised by different stakeholders concerning medical app development which might be of interest.1. The motivation for the app development is misguided. Regardless of the elegance, ease of use, enjoyable experience, or other appeal of a health app, if it does not address a specific problem, it will not be considered useful and subsequently not adhered to. Just monitoring a physiologic parameter, a person’s mood, or collecting data because an app is able to do so is a recipe for failure. People searching for health apps (and health information in general) are likely doing it because of a health problem. Data must be collected and filtered in a way that it translates a message to the end-user, whether that be a patient or clinician.2. Lack of clinician involvement. I am not saying here that clinicians need to be CEOs of mHealth companies. What I am alluding to is the lack of clinicians’ input at all in the development of many of the technologies. Technologies do not operate in a vacuum. There are processes that the technology fits into which might very well need to be totally redesigned around the technology (this is a good thing, for many processes need changed). These processes may range from someone’s personal schedule to instituting hospital case managers who advise patients on mobile apps. The app cannot be dropped on the lap of a CIO or clinician and be expected to be successful. Connectivity of mHealth tools will be an important aspect of stage 3 of Meaningful Use adoption.This connectivity will necessitate workflow of data and messaging between patient and clinician. It is imperative, therefore, to have clinician input into the design of the technology.
The Bipartisan Policy Report titled “What is Driving US Health Care Spending? America’s Unsustainable Health Care Cost Growth” issued in September lists seven factors increasing American health care costs. The “fiscal cliff” debates include many of these arguments.While these factors do indeed play roles in American health care, almost all are at work in other industrialized countries, all of whom provide better care to more people for half what we spend. Good intentions aside, the report overlooks critical (and dysfunctional) characteristics of American health care and instead distracts itself with factors never mastered by any country (including ours).The report was prepared under the direction of former Senate majority leaders Tom Daschle (D-S.D.) and Bill Frist (R-Tenn.), former Senator Pete Domenici (R-N.M.) and former Congressional Budget Office Director Dr. Alice Rivlin. With such participants, the report certainly qualifies as bipartisan, but unfortunately the final product does not qualify as accurate.1. Many industrialized countries pay providers on a fee-for-service basis, seemingly rewarding more care rather than better care. Yet their costs are lower and their citizens are healthier.2. Other countries face aging populations with higher smoking rates and more chronic illnesses than we have. Yet their costs are lower and their citizens are healthier.
The health care social media legal series continues here on Healthin30, and legal expert, David Harlow, Esq, Health Care Attorney and Consultant at The Harlow Group, LLC in Boston, answers a series of questions focusing on the legal aspects of physicians engaging in social media.Q: Barbara – According to the American Medical Association, it states: “When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.”A: David Harlow, Esq. – The peer reporting laws and regulations of each state’s medical board generally establish the duty of a physician regarding peer monitoring and reporting. It is a condition of each physician’s license to monitor colleagues and report infractions — whether related to clinical issues or matters of candor, privacy and integrity, as outlined above.Q: Barbara – Can a consumer or patient report inappropriate physician behavior? Who would they report it to?A: David Harlow, Esq. – The state medical board is the governmental authority that would investigate such allegations. There are also professional societies, employers, medical staff organizations and hospitals or other facilities where the clinician has privileges that may have relevant polices in place regarding inappropriate use of social media. It is often the case that some of such organizations will respond more rapidly to an allegation of such inappropriate behavior than the state agency would.
The number of technical tools available to help patients live healthy lifestyles or control chronic health conditions has grown considerably during the past few years. But the percentage of patients who use some form of technology, such as mobile apps, to track health indicators has remained virtually unchanged for three years.The Pew Internet & American Life Project published a report Jan. 28 that found 69% of U.S. adults track at least one health indicator such as diet, exercise or weight. The survey of 3,014 adults conducted between Aug. 7 and Sept. 6, 2012, found that 49% monitor their progress in their heads, 34% track the information on paper, and 21% utilize some form of technology, including mobile apps, which 7% use. The results mirror findings from a Pew survey in 2010.As a tech industry thought leader, Im disappointed when I see a survey like that, said Bill Crounse, MD, senior director of worldwide health at Microsoft Corp. But as somebody who has served as a physician and was involved in patient care for 20 years
Im not particularly surprised.Dr. Crounse said most people have an idea of what they weigh because they occasionally step on a scale. But a much smaller population would write that number down, enter it into a patient portal or document it through a mobile app.
With more electronic health record systems continuing to fall short of providers' expectations, a new report by Black Book Rankings suggests that 2013 may indeed be the "year of the great EHR vendor switch."
The survey also revealed that some popular "one size fits all" EHR products have failed to meet the needs of several medical specialties and cannot continue to satisfy their client base with a lack of customizable or bespoke tools. As far as EHR systems meeting the expectations of various medical specialities, nephrologists reported the highest rate of discontent, with 88 percent saying their EHR systems fail to meet their needs. Providers in urology, ophthalmology and gastroenterology also reported high rates of discontent. Contrastingly, a much lower number of small practice physicians (54 percent) reported that their system failed to meet their needs.
For sticking it to fraudulent pharmaceutical sellers. Sproxil has developed a game-changing approach to help eliminate the fake drugs that kill more than 700,000 people around the world each year. When patients receive their medications, they simply scratch off a sticker label to reveal a code, then text it to Sproxil, which verifies its authenticity. Last year, the company crossed the 2-million-use threshold and launched a partnership with IBM to analyze customer data so they could discern drug-counterfeiting patterns. Sproxil has since expanded to several other fields in need of product verification, from agricultural goods to auto parts.For bridging the healthcare gap with telecom. Safaricom first won international attention for dramatically expanding banking in Kenya by providing financial services over the phone. Now, it’s doing the same for healthcare with Daktari 1525, a call-in service launched in late 2011. For a small fee, Kenyans can phone a doctor 24 hours a day, giving them access to basic medical advice in a country where healthcare providers are in ridiculously short supply. Safaricom recently launched a budget-friendly smartphone called Yolo, which is also the first Intel-powered phone to reach Africa.For bringing design to third-world healthcare. While access to healthcare in developing countries has improved, new patients often shy away from (if not scoff at) providers who use today’s typically expensive and complex tools and machinery. D-Rev aims to bridge the gap by designing top-quality products that can be built affordably, then partnering with distributors to bring them to market. Last year, it launched Brilliance, a scaled-down phototherapy lap for infant jaundice that costs a fraction of the price of competing products.
When influenza hit early and hard in the United States this year, it quietly claimed an unacknowledged victim: one of the cutting-edge techniques being used to monitor the outbreak. A comparison with traditional surveillance data showed that Google Flu Trends, which estimates prevalence from flu-related Internet searches, had drastically overestimated peak flu levels. The glitch is no more than a temporary setback for a promising strategy, experts say, and Google is sure to refine its algorithms. But as flu-tracking techniques based on mining of web data and on social media proliferate, the episode is a reminder that they will complement, but not substitute for, traditional epidemiological surveillance networks.“It is hard to think today that one can provide disease surveillance without existing systems,” says Alain-Jacques Valleron, an epidemiologist at the Pierre and Marie Curie University in Paris, and founder of France’s Sentinelles monitoring network. “The new systems depend too much on old existing ones to be able to live without them,” he adds.This year’s US flu season started around November and seems to have peaked just after Christmas, making it the earliest flu season since 2003. It is also causing more serious illness and deaths than usual, particularly among the elderly, because, just as in 2003, the predominant strain this year is H3N2 — the most virulent of the three main seasonal flu strains.
An OB-GYN is in the middle of a social media maelstrom after complaining about a patient on her Facebook page. Dr. Amy Dunbar, 33, of St. John's Mercy Medical Center in St. Louis, Mo., posted on the social networking site in late January about a patient who continually showed up late to her scheduled appointments. Dunbar wrote:"So I have a patient who has chosen to either no-show or be late (sometimes hours) for all of her prenatal visits, ultrasounds and NSTs. She is now 3 hours late for her induction. May I show up late to her delivery?"When asked in the comments why she didn't cancel the procedure or transfer the woman to another doctor, Dunbar stated that the patient had previously endured a stillbirth. The post was publicly visible and not restricted to Dunbar's 470 friends.A woman named Amanda Johnson took a screenshot of Dunbar's status, and, apparently outraged at what she saw as unprofessional conduct, posted the image to a Facebook group run by Dunbar's hospital, Mercy Moms To Be.A comment war broke out on the group's Facebook page, with many angry commenters demanding the hospital fire or otherwise discipline Dunbar — despite the fact that the hospital later determined that no patient privacy laws were broken.
As they do every time they expect to come into extra money, the partners at Acacia Internal Medicine Specialists talked about what to do with a bonus from the meaningful use incentive program.The three-physician, four-nurse practitioner practice in Phoenix was building a new facility when the incentive program was announced, so by the time the checks arrived, the investments needed to bring the technology infrastructure to meaningful use readiness had already been made. But there was a community room in the new building that the group had envisioned as space for wellness classes. Together, they decided their meaningful use checks would go toward hiring a teacher to conduct weekly tai chi classes. They also made other small technology purchases to improve the existing IT.The question of what to do with meaningful use money is one that every practice needs to discuss early on, as the Acacia practice did, before each physician goes through the attestation process. Being on the same page not only will help a practice achieve its goals, which very well could be contingent on everyone receiving the maximum incentive amount, but it also could prevent hurt feelings. In addition, it could avoid a lawsuit if a physician thinks he is entitled to pocketing money that the practice expects to keep.
To ensure that all attendees have an exceptional conference experience, HIMSS has created a series of highly interactive webinars to highlight the many opportunities available for first-time attendees, experienced attendees, or for those attending virtually.JoAnn W. Klinedinst is Vice President, Professional Development, at HIMSS. As a member of the HIMSS senior management team since 2006, Klinedinst brings more than 23 years of progressive experience in the health IT and management systems industry to the Society. She is responsible for all aspects of programming for professional development perspectives including annual conference, distance education, virtual conference, webinars, e-seminars, web services, professional certification, career services, continuing education, and HIMSS member awards. Before this appointment, Ms. Klinedinst served as HIMSS content staff liaison to the enterprise and management engineering/process improvement steering committees, working with volunteers to deliver tools and resources to members. Karen J. Malone is Vice President of Meeting Services for HIMSS. Malone joined HIMSS in November, 1997 and has nearly 20 years in the meetings industry. At HIMSS, Karen oversees nine staff in the planning of an Annual Conference & Exhibition, a $22 million event, ranked as show #49 on the nation’s top Tradeshow 200 list, with more than 1,100 exhibitors and 32,000 attendees. HIMSS also hosts 80+ small to mid-size meetings each year as well as a conference in Europe and Asia. Under Malone's leadership, HIMSS10 received one of the highest honors in the trade show industry when the conference was recognized as, “The Show with the Most Innovative Practices,” at the Trade Show Executive Gold 100 Awards & Summit.
The trajectory of digital health is, in part, driven by Eric Topol. A cardiologist, author (The Creative Destruction of Medicine) and futurist, Dr. Topol provides some of the essential “glue” to this important health movement. His voice is clear and resonant and I recently served up 10 quick question to get his up-to-date perspective on digital health.Digital health—or my preferred term “digital medicine”—refers to the ability to digitize human beings, by a variety of means (sequencing, sensors, imaging, etc.) fully exploiting our digital infrastructure of ever-increasing bandwidth, connectivity, social networking, the Internet of all things, and health information systems.2. What are the therapeutic categories that will benefit most? And which are farther down the list?We are ending the era of medical information asymmetry, with most/all information in the doctor’s domain. The consumer is now center stage—he/she will drive this new medicine with a rebooted model of physician partnership. It is the consumer’s data, the consumer’s smartphone, and the consumer’s choice of who, when and how to share.4. How does telemedicine augment the evolution of digital health? Will patients need a device to more effectively communicate with a healthcare professional?Use of secure video, virtual office visits to substantially replace physical visits, and remote monitoring to pre-empt the need for hospitals (except for the critically ill and surgical operations, medical procedures) can all be fostered with advanced telemedicine solutions, sensors, biocomputing, AI, predictive analytics, and the current digital landscape.
The author insists that patient-centered patient care cannot be realized without Interoperable EHRs shared by all the stakeholders and providers OPINION – January 30, 2013 -- You will recall in my article last December, about my healthcare experience outside of Oregon, that both the ear doctor and the neurosurgeon professed to have electronic health records (EHRs).The ear doctor advised that he was using the aircraft control type headset to dictate into my medical record, by pushing the button in his ear.When I corrected him, he would re-dictate the correction. The neurosurgeon was complaining about a most popular vendor's EHR, why it did not work for him and the inflexible nature of the product and the company. I mentioned that I had heard that the company thought it was preferable to make no or very little changes for clinicians because it could reduce errors. Neither I nor the clinician seemed to understand this concept, particularly if the physician had to design his or her own workaround or the EHR was not really useful to him.The ear doctor was in private practice, and affiliated with one health system. The neurosurgeon worked for a medical group contracting with a medical foundation owned by a non-profit hospital system. When I went to the neurosurgeon, I wondered why he did not have access to the EHR that the ear doctor had dictated into. Maybe they did not have the same EHR product, maybe they were the same product, but they were not interoperable, maybe no one designed the interface for them to be interoperable.
These days, I look at a lot of websites describing some kind of product or solution related to the healthcare of older adults. Sometimes it’s because I have a clinical problem I’m trying to solve. (Can any of these sleep gadgets provide data — sleep latency, nighttime awakenings, total sleep time — on my elderly patient’s sleep complaints?)In other cases, it’s because a family caregiver asks me if they should purchase some gizmo or sensor system they heard about. (“Do you think this will help keep my mom safe at home?”)So far, it’s been a bit of a bear to try to check out products. Part of it is that there are often too many choices, and there’s not yet a lot of help sifting through them. (And research has shown that choices create anxiety, decision-fatigue, and dissatisfaction with one’s ultimate pick.)But even when I’m just considering a single product and trying to decide what to think of it, I find myself a bit stumped by most websites. And let’s face it, if I visit a website and it doesn’t speak to my needs and concerns fairly quickly, I’m going to bail. (Only in exceptional cases will I call or email for more information.)
For whatever reason – whether it’s budget, time, buy-in or understanding – healthcare hasn’t fully embraced social media. But luckily the ePatient movement has already—perhaps unknowingly—done the grunt work and outlined the tenets of realizing social media’s value in healthcare. Patient engagement thought leaders, such as Dave deBronkart (@ePatientDave), have been indirectly driving home the values of optimal social media use for quite some time.In the following Perspectives by Fenton + TEDMED video, ePatientDave with commentary from James Merlino, Chief Experience Officer at the Cleveland Clinic, outline the “5 Es of the ePatient,” which parallel the values health organizations should keep in mind when engaging their audiences using social media.
5 Es of the ePatient and social media
Let’s take a look at the “5 Es of the ePatient” Dave mentioned in the video, and connect them with social media:Patients can always find a new doctor, hospitals a new technology, companies a new consultant. The name of the game in social media is value – and when done with the consumer at heart, we are only looking at a brighter and healthier healthcare ecosystem.Stay tuned for Part 2! In the meantime, let’s get going! What challenges do you currently face in developing a social media strategy?
Mobile health is one of the more transformative developments in healthcare, according to Patricia Abbott, associate professor of nursing at the University of Michigan, School of Nursing, Division of Nursing Business and Health Systems. "The real winners will be the ones who grab on in the front end, and don't wait," she says.The future of mHealth will be one in which, "in a very short period of time, we’ll look back and we won’t believe we didn't have it." The speed at which mHealth is becoming mainstream "goes hand in hand with the way technology is changing and the way people are thinking,” Abbott says. “People who have grown up with computers fundamentally think differently."Abbott strongly believes mHealth is about "liberating the data" – making maintenance of health something irrelevant to time and place. She also predicts that wearable technology is going to become a way of life.Abbott likens the advent of mHealth to Karios, the Greek god of the opportune moment. "He is a fast-moving entity. You are only able to grab onto him when he’s coming toward you. If you miss the opportunity, you miss it; it will be hard to catch him."Abbott recently conducted research in some of Baltimore's economically challenged neighborhoods, using mobile devices to increase the level of care given to patients with chronic disease. She believes it will be a very short time until mobile healthcare will be used on a regular basis.
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