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Can Healthcare IT Abolish a Disease?

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A week after the craziness that is HIMSS (there’s a reason the #HIMSSanity hashtag has done so well), I’m kicking around an idea that came to my mind on my flight home from HIMSS. Overwhelmed by the 5 days of in depth discussions, I closed out my HIMSS talking about healthcare IT with the lovely lady sitting next to me. It just so happened that she was a HIE coordinator at a hospital in California and was heading home from HIMSS as well.

We had a far reaching discussion on the 5 or so hour flight home from Orlando. At one point we started the discussion of personalized medicine. I think I freaked her out a little bit when I mentioned the concept of every organ having an IP address.

Our discussion prompted to me to consider this really interesting an important question:

Can we abolish a disease because we’re so good at predicting that disease that we prevent it from ever happening?

When I considered this idea, it reminded me of Bill Gates (and many others) efforts to literally eradicate Polio from off the face of the earth. They’re doing so using vaccines and I can’t remember the exact timeline, but they’re only a few years out from this goal. It’s so empowering to think about eradicating a disease. Could health IT have a similar impact?

I haven’t thought through all the diseases and all the technology that could benefit from this concept, but I’m quite certain this is the real future of healthcare IT. How wonderful would it be to work on a project that determined the cause of diabetes early enough that we no longer had diabetics? What if we no longer had coughs and colds because we could identify the warning signs early enough that we could stop them from ever happening? We just need to get past the beauracracy and regulation and on to solving these major problems. No doubt this will take an enormous effort and resources and people beyond the traditional health IT.

This is a lofty concept indeed. However, I don’t think these ideas are that far away. What do you think? Could healthcare IT be used to abolish a disease?

March 7, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Connecting Smart Mobile Devices to the EHR

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My colleague, John Lynn, posted a hilarious CES marketing video advertising a new product it calls the iOximeter.  The iOximeter, which operates on both the iOS and Android platforms, is an independent device which attaches to smart phones, turning the phone into a pulse oximeter.

I strongly suspect that an i-glucose meter, i-scale and i-blood pressure cuff designed for the mass consumer market are starting to make major headway.

Not to be Scrooge at the Christmas party — I think such devices are a very positive development — but I’m left wondering what the purpose of getting the data onto the phone really is.  After all, unless the data gets to a physician conveniently, and ideally comes to live in their EMR, just how much good does it do?

On the consumer side, it does little but add bells and whistles to products consumers are increasingly used to using anyway, given that the price point for these devices is low enough that they’re sold in consumer pharmacies.

On the provider side meanwhile, you’re left with data that, while it might be arranged in pretty charts, doesn’t integrate itself easily into clinicians’ work flow.  And with EMRs already dumping huge volumes of data into their laps, some physicians are actively resisting integrating such data into the records.

No, the existing arrangement simply doesn’t do anything for clinicians, it seems.  Yes, consumers who are into the whole Quantified Self movement might find collecting such data to be satisfying, but the truth is that at this point many doctors just don’t want a ton of consumer-driven data added to the mix.

To make such phone-based devices useful to clinicians, someone will probably have to create a form of middleware, more or less, which accepts, parses, and organizes the data coming in from mobile health app/device combos like these.  When such a middleware layer goes into wide use, then you’ll see hospitals and doctors actively promote the use of these apps and devices.  Until then, devices like the iOximeter aren’t exactly toys, but they’re not going to change healthcare either.

January 9, 2014 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Parents Using PHRs More Likely To Get In All Well-Child Visits

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Parents using an integrated PHR were more likely to take their young children to all recommended well-child visits, according to a Kaiser Permanente study reported in iHealthBeat.

More than 4.3 million members are registered to use Kaiser’s PHR, My Health Manager, on kp.org. During the first half of this year, patients have viewed 17.5 million lab test results, sent 7.4 million secure e-mails to their care providers, refilled 7.1 million prescriptions and scheduled 1.8 million appointments, reports News-Medical.

The study, which was published in The Journal of Pediatrics, analyzed data on more than 7,000 children ages zero to two living in the Northwest U.S. and Hawaii.  The children were enrolled in KP health plans between January 2007 and July 2011.  To determine the appropriate number of well-child visits, researchers  used performance measures listed in the 2010 Healthcare Effectiveness Data and Information Set that state that children aged 0 to 15 months should attend at least six well-care visits, News-Medical says.

The study found that in the Northwest region, children whose parents used the Kaiser PHR during the study period were 2.5 times more likely to bring their child to the recommended number of well-child visits. These children were also 1.2 times more likely to get all of their immunizations.

In Hawaii, meanwhile, children in this group were two times more likely to get all well-child visits, but results related to immunizations were statistically insignficant, iHealthBeat notes.

While it may be too soon to call it a trend, this is one of a growing number of projects which use the PHR concept to help patients engage and take responsibility for their health behaviors.

For example, this summer Howard University Hospital rolled out a mobile PHR for pre-diabetic young adults designed to help them take control of their health.  Howard has given the young adults in the program — aged 18 to 24 and diagnosed with pre-diabetes — access to a mobile version of the NoMoreClipboard PHR for their smartphones.

The program sends a variety of text messages to the young adults targeted by this intervention, which include reminders to interact with the PHR. The program participants are also given a FitBit Zip wireless activity tracker which keeps track of steps taken, distance covered and calories burned per user.

Projects like these, which help patients make the PHR the fulcrum point for better health, are a smart way of using the technology. I expect to see a great deal more of this “PHR=patient engagement=better health” model going forward.

October 18, 2013 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Is the ‘Internet of Things’ Health IT’s Next Big Thing?

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Gartner Inc. has come out with a bullish report on the “internet of things,” which it predicts will add nearly $2 trillion in value to the economy by 2020 and transform the way all businesses operate.

As many as 30 billion devices with unique IP addresses will be connected, the majority of them being products, according to Gartner. That’s compared with a 2009 figure of 2.5 billion, 80 percent of them being devices such as laptops and phones.

One of the most often quoted descriptions of the internet of things comes from Helen Duce, director of the RFID Technology Auto-ID European Centre at the University of Cambridge: “We have a clear vision: to create a world where every object — from jumbo jets to sewing needles — is linked to the Internet.”

Health care would, of course, be part of the vision, which Gartner, a Stamford, Conn.-based IT research and advisory firm, calls the Digital Industrial Economy. The sector receives prominent billing, along with retail and transportation, in Garner’s latest news release on the topic.

The thinking is that physical objects — ”from roadways to pacemakers,” as McKinsey & Co. put it in one report — will produce constant data streams that can be analyzed and acted on. The possibilities for systems such as inventory control are obvious enough, as the inventory would report on itself.

In health care, a major application could be in patient monitoring. Marketplace has quoted Dr. Anthony Jones of Philips Healthcare on the possibilities: ”If I now have a continuous monitor, and I have that data going up into a central repository, I can write algorithms and put some intelligence into that repository that allows me to look for trends. So part of what the Internet of things will allow is much more sophisticated, much more continuous monitoring.” Sounds a bit like what John described in his post “Every Organ Will Have an IP Address.”

It sounds promising. But it also sounds much more incremental than it’s being portrayed by Gartner and other consultants.

Consider how Peter Sondergaard, senior vice president at Gartner, explained the future in a recent talk covered by ZDNet:

“The Digital Industrial Economy will be built on the foundations of the Nexus of Forces (which includes a confluence and integration of cloud, social collaboration, mobile and information) and the Internet of Everything by combining the physical world and the virtual.”

The predictions — Sondergaard said every object costing more than $100 will be smart by 2020 — look optimistic. Or pessimistic, depending on how you look at it: Gartner also estimates that one in three knowledge workers will be displaced by the new technologies.

About 60 percent of respondents to Gartner’s own recent CEO survey said the idea that the internet of things would replace millions of workers over the next decade-and-a-half was a “futurist fantasy,” according to SiliconANGLE. In health care, it’s hard to imagine that CIOs have much attention to devote to the internet of things amid the Meaningful Use and ICD-10 requirements they’re up against, although, as Jennifer Dennard wrote, health IT nowadays is much more than that.

The internet of things will get here. But it will probably develop in a piecemeal fashion, not in the dramatic way that Gartner envisions. Lots of “things” will get connected as companies see business reasons to put sensors in and bring them online. It will arise ad hoc from existing projects, with some industries joining the trend earlier than others.

When it does get here, there’s a good chance it won’t even be called the internet of things. In 2005, after all, Gartner was calling it the “real-world web.”

It was also predicting: “By 2015, wirelessly networked sensors in everything we own will form a new Web.”

October 17, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

“OK Glass — Go to Lab Results”

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The following is a guest post by Jon Fox MD, Founder of HealthApp Connect.
Jonathan Fox
This changes everything.

Last week I had the opportunity to demo Google Glass. I test drove the Glass of one of the four thousand “Explorers” who were lucky enough to “win” a pair of specs from Big G. And as a healthcare provider, I must say that it knocked my socks off.

As you probably know, Google’s innovative Glass is a small rectangular mirror held in front of your right eye by a lightweight titanium band. You turn on your Glass by tapping this band, or alternatively tilting your head back. Then a transparent prompt appears in front of your eye at a comfortable fixed focal length. I presume if you’re visually challenged, a corrective lens can be added to the otherwise glassless frame.

Responding to the prompt, I said “OK Glass, take a picture” and it took a photo of the person in front of me. “OK Glass, take a video” launched a 10 second video recording. When I said “OK Glass, send text message”, I was asked by a pleasant female voice to whom I wanted it sent. The voice seemed to come from inside my skull, and I’m told that sound is conducted via your temporal bone, providing an intimate and pleasing aural experience.

I could also navigate by swiping or tapping the touchpad built into my “sky blue” titanium frame. Although physicians may find that talking to or playing with their specs is not appropriate in a clinical setting, I expect commands someday will be relayed from an inconspicuous wristband or belt, or even eye tracking gestures.

Currently Google Glass is tethered to your smartphone’s internet connection and transported in a protective bag. Battery life is a few hours at best, and functionality is still not clear. But “Glassware” has already been produced by app makers at Twitter and Facebook, and some independent engineers are building apps for use in the operating room or medical education.

But to me as a healthcare provider, Glass’s really exciting future lies in the EMR space. First, its form compels a user interface that is both simple and unobtrusive, a holy grail for EMRs. Second, it allows us clincians to maintain eye contact with our patients and does not interfere with our natural workflow, two big drawbacks of EMRs. And third, it lets us work like professionals rather than data entry clerks. Primary care physicians may even become “cool”, or at least not called “a vanishing breed”.

Of course, existing EMRs cannot merely be transferred to Google Glass. They will need to be redesigned from the ground up, hopefully this time with input from healthcare providers and consumers. Here’s an example:

Google hopes to make Glass available to the public by the end of the year. For $1500 and a carrier charge of $40 per month, ordinary people will be able to document their every moment. Some backlash to this threat to our privacy is already appearing, such as “Ban the Glass” signs. However, within the Healthcare Industry, such concerns likely will be trumped by its obvious usefulness and HIPAA guidelines. Hopefully, the powerful EMR companies will rise up to meet the challenge, but I suspect Google Glass is going to disrupt their legacy businesses in a big way.

This changes everything.

July 17, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

The Rise Of mHealth And EHR Use, And The World Of Telehealth – Around Healthcare Scene

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mHealth is on the rise, and it looks like usage of smart phones among physicians is following that same trend. A recent study shows that usage rose about nine percent in 2012, which shows that it is becoming more accepted in the medical world. It will be interesting to see if it increases even more this year (I have a feeling it might.)

Similar to the increase in doctors using smartphones, there has been a jump in EMR and HIE use as well. A survey from Accenture found that over 90 percent of doctors are using an EMR in either their practice or at a hospital, and over 50 percent are using an HIE. This increase was highest among doctors in the United States. Be sure to read more of the interesting facts this survey found about EMR and HIE use in the U.S., and around the world.

Even though 90 percent of doctors are using an EMR at one point or another, only about 55 percent have actually adopted an EHR into their practice. It can be nerve-racking trying to find the perfect EHR. If you are finding yourself at that crossroad, be sure to read these five tips from ADP AdvancedMD on how to have a successful EHR implementation.

Still, some of you may be hesitant to implement an EHR. You may ask, is it worth it? Does it takeaway from healthcare? There is debate from both sides, each with compelling arguments. John believes that technology is overall positive in any industry, and discusses his thoughts, and some of the challenges that faces the industry.

Telehealth and medicine is so huge, it can be hard to digest. Neil Versel recently attended the American Telemedicine Association’s annual conference in Austin, Texas, and saw just how huge this market was. Be sure to check out this video he created from his experience, and to perhaps get a better idea about the many types of telehealth. Similar to the increase in doctors using smartphones, there has been a jump in EMR and HIE use as well. A survey from Accenture found that over 90 percent of doctors are using an EMR in either their practice or at a hospital, and over 50 percent are using an HIE. This increase was highest among doctors in the United States. Be sure to read more of the interesting facts this survey found about EMR and HIE use in the U.S., and around the world.

With summer quickly approaching, it’s more important than ever to stay hydrated. But if you need a little reminder, be sure to look into the Jomi Band.  It gives you warnings when you might be on the brink of dehydration, and makes it easy to keep track of how much water you’ve consumed in a day’s time.

May 12, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

User-friendly EMRs, Meaningful Use Fraud, and DietBet – Around Healthcare Scene

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Many are concerned with the user experience in Health IT – particularly regarding the user-friendliness of EMRs. While it is easy to be overwhelmed by the negative reports, there are businesses and providers working hard to resolve these issues. McKesson is one of those companies, and they were recently recognized for their work at HIMSS13. Will more companies start making efforts like this? 

One step toward making EMRs more user-friendly is, well, making them accessible to patients. Unfortunately, according to a recent Accenture study, 65 percent of doctors believe patients should only have limited access to their health records, and 4 percent believe records should be totally closed. Reasons range from self-consciousness of what a doctor says in a record, to being uncomfortable with using digital records. Allowing patient-access may very well be a huge cultural shift for doctors everywhere.

In order to pass Meaningful Use stage 1, one must indicate which EMR was adopted. But, according to BuildYourEMR.com’s CEO, Mike Jensen, 74 percent of the providers who stated they were using his EMR…weren’t. If this is similar across the board, around 5.4 billion dollars were paid in error for incentives. While this isn’t likely to be the case, it’s pretty sad the lengths people will go to in order to get some extra money. EMR vendors need to start going over their CMS data in order to help prevent this fraudulent behavior.

If money was at stake for you to lose weight, would that motivate you? For most people, it probably would. DietBet takes the desire people have to lose weight and pairs it with the innate desire to have money, and creates a weight-loss game. If you lose 4 percent of your body weight in four weeks, you get part of the money pot for the group you are in. If you don’t, you lose the amount you paid to participate in the first place.

John recently had the opportunity to go to TEDMED as a guest of the Breakaway Group (A Xerox company)
. It was a great experience for him, and highlights can be found @ehrandhit or searching #simplehealth on Twitter. John recounts some of key takeaways from TEDMED, and suggests some of the major themes that will likely be seen in healthcare.

April 21, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Effortless EHR Interaction

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I recently came across the really interesting device called MYO. I really can’t do the device justice, so I’ll just share this video which will do a much better job showing the gesture controls that are possible with the MYO.

I love how it senses even changes in the muscle. I love when description that says that the response sometimes feels like it responds before you even move since it senses your muscle before the movement is even done. Pretty amazing.

There are has to be so many possible uses for a next generation gesture device like MYO in healthcare. I’ve been thinking a lot about effortless EHR interaction and where it could go. I wonder if MYO and other gesture control systems can dramatically improve a physician’s interaction with an EHR.

Plus, the most exciting thing of all is that I think we’re still in the very early days of what’s going to be possible with gesture control and human computer interaction in general. Pair this with always on ubiquitous computing like is being shown with Google Glass and we’re just at the very beginning of the computing revolution.

I guess we’ll see if healthcare decides to lag behind these new technologies or whether we’ll ride the wave of transformation.

April 9, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

The Health IT Tablet Shift and Some Hope for Windows 8

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One of the most amazing shifts that we’ve seen in healthcare is the acceptance of the tablet form factor. I’ve been fascinated with tablets since they first came out. The idea was always great, but in implementation the idea always fell apart. Many a sales rep told me how the tablet was going to be huge for healthcare. Yet, everyone that I know that got one of the really early tablets stopped using it.

Of course, the tablets that I’m referring to our the pre-iPad tablets. As one Hospital CTO told me at HIMSS, “the iPad changed tablets.

It’s so true. Now there isn’t even a discussion of whether the tablet is the right form factor for healthcare. The only question I heard asked at HIMSS was if a vendor had a tablet version of their application. In fact, I’m trying to remember if I saw a demo of any product at HIMSS that wasn’t on a tablet. Certainly all of the EHR Interface Improvements that I saw at HIMSS were all demonstrated on a tablet.

As an extension of the idea of tablets place in healthcare, I was also interested in the healthcare CTO who suggested to me that it’s possible that the Windows 8 tablet could be the platform for their health systems mobile approach. Instead of creating one iPad app that had to integrate all of their health system applications, he saw a possibility that the Windows 8 tablet could be the base for a whole suite of individual applications that were deployed by the health system.

I could tell that this wasn’t a forgone conclusion, but I could see that this was one path that he was considering seriously when it came to how they’d approach mobile. I’m sure that many have counted out Microsoft in the tablet race. However, I think healthcare might be once place where the Windows 8 tablet takes hold.

When you think about the security needs of healthcare, many hospital IT professionals are familiar with windows security and so they’ll likely be more comfortable with Windows 8. Now we’ll just have to see if Windows 8 and the applications on top of it can deliver the iPad experience that changed tablets as we know them.

March 20, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Around Healthcare Scene: EMRs and Health Technology Talk

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EMRs are supposed to increase efficiency and patient care. However, because of the amount of data they contain, sometimes the opposite happens. Anne Zieger discusses a recent report in Modern Healthcare, which talks about how nearly 30 percent of PCPs claim that they missed notifications of test results, leading to a delay in care, thanks to the over-abundance of information the EMR collects.

Would the use of mHealth technology such as tablets and smart phones cause harm like this as well? We’re sure to find out soon with mobile technology advancing among providers. Research shows that some providers are “gradually shifting their use of smart mobile devices from business functions like e-mail and scheduling to a much wider range of activities. Be sure to read some of Anne’s thoughts on the matter, and find out if this growth will continue at this pace.

And speaking of tablets, around 4,000 home care staff will be receiving a brand new Android tablet. Bayada, a national home care agency has recently sent out Samsung Galaxy Tabs to therapists, medical social workers and other home health professionals. Considering the fact that iPads are often the tablet of choice, this was an interesting move. The workers can document information while at a patient’s home, as well pull up data before going to the house. Will more healthcare providers be taking on the Android tablets, because of their lower cost? Chime in over at Hospital EMR and EHR.

There’s always some kind of new app being created to help people keep track of their health. Now, people can use uChek, an at-home urinanalysis, to keep their health in check. The mobile app, along with the uChek kits, allow people to test their urine for a variety of different markers. While it shouldn’t be used to replace a necessary visit to the doctor’s office, it could help prevent certain issues from getting worse by catching them early on.

With all this talk of technology in the healthcare world, one might wonder how it affects patient engagement. We recently switched pediatricians for my house, and while the last office was very tech savvy, this new office doesn’t have a computer in the offices, they give out paper prescriptions, and they have paper files. And to be honest, I love this office way more because of how personal the visit was, with no technology to distract the doctor. At our old office, the doctor stood far away from us, only looked at the computer the majority of the time, and it just wasn’t personal. However, because a lot of the mHealth technology does a lot of good, Dr. West over at the Happy EMR Doctor has some suggestions. He has created a list of 7 tips to help improve EHR etiquette, and this is definitely something all healthcare providers should follow. Just because there’s technology, doesn’t mean the importance of patient engagement should disappear as well.

March 10, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.