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Improving Clinical Workflow Can Boost Health IT Quality

Posted on August 18, 2016 I Written By

Anne Zieger 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.

At this point, the great majority of providers have made very substantial investments in EMRs and ancillary systems. Now, many are struggling to squeeze the most value out of those investments, and they’re not sure how to attack the problem.

However, according to at least one piece of research, there’s a couple of approaches that are likely to pan out. According to a new survey by the American Society for Quality, most healthcare quality experts believe that improving clinical workflow and supporting patients online can make a big diference.

As ASQ noted, providers are spending massive amounts of case on IT, with the North American healthcare IT market forecast to hit $31.3 by 2017, up from $21.9 billion in 2012. But healthcare organizations are struggling to realize a return on their spending. The study data, however, suggests that providers may be able to make progress by looking at internal issues.

Researchers who conducted the survey, an online poll of about 170 ASQ members, said that 78% of respondents said improving workflow efficiency is the top way for healthcare organizations to improve the quality of their technology implementations. Meanwhile, 71% said that providers can strengthen their health IT use by nurturing strong leaders who champion new HIT initiatives.

Meanwhile, survey participants listed a handful of evolving health IT options which could have the most impact on patient experience and care coordination, including:

  • Incorporation of wearables, remote patient monitoring and caregiver collaboration tools (71%)
  • Leveraging smartphones, tablets and apps (69%)
  • Putting online tools in place that touch every step of patient processes like registration and payment (69%)

Despite their promise, there are a number of hurdles healthcare organizations must get over to implement new processes (such as better workflows) or new technologies. According to ASQ, these include:

  • Physician and staff resistance to change due to concerns about the impact on time and workflow, or unwillingness to learn new skills (70%)
  • High cost of rolling out IT infrastructure and services, and unproven ROI (64%)
  • Concerns that integrating complex new devices could lead to poor interfaces between multiple technologies, or that haphazard rollouts of new devices could cause patient errors (61%)

But if providers can get past these issues, there are several types of health IT that can boost ROI or cut cost, the ASQ respondents said. According to these participants, the following HIT tools can have the biggest impact:

  • Remote patient monitoring can cut down on the need for office visits, while improving patient outcomes (69%)
  • Patient engagement platforms that encourage patients to get more involved in the long-term management of their own health conditions (68%)
  • EMRs/EHRs that eliminate the need to perform some time-consuming tasks (68%)

Perhaps the most interesting part of the survey report outlined specific strategies to strengthen health IT use recommended by respondents, such as:

  • Embedding a quality expert in every department to learn use needs before deciding what IT tools to implement. This gives users a sense of investment in any changes made.
  • Improving available software with easier navigation, better organization of medical record types, more use of FTP servers for convenience, the ability to upload records to requesting facilities and a universal notification system offering updates on medical record status
  • Creating healthcare apps for professional use, such as medication calculators, med reconciliation tools and easy-to-use mobile apps which offer access to clinical pathways

Of course, most readers of this blog already know about these options, and if they’re not currently taking this advice they’re probably thinking about it. Heck, some of this should already be old hat – FTP servers? But it’s still good to be reminded that progress in boosting the value of health IT investments may be with reach. (To get some here-and-now advice on redesigning EMR workflow, check out this excellent piece by Chuck Webster – he gets it!)

One Example Of Improving Telehealth Documentation 

Posted on August 16, 2016 I Written By

Anne Zieger 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.

Over the past year or two, the pressure has risen for providers to better document telehealth encounters, a pressure which has only mounted as the volume of such consults has grown. But until recently, telemedicine notes have been of little value, as they’ve met few of the key criteria that standard notes must meet.

The fact that such consults aren’t integrated with EMRs has made such an evolution even trickier. I guess doctors might be able to squeeze the patient’s video screen into one corner, allowing the clinician to work within the existing EMR display, but that would make both the consult and the note-taking rather inefficient, wouldn’t it?  The bottom line is that if telemedicine is to take its place alongside of other modes of care, this state of affairs is unsustainable.

For one thing, health plans that reimburse for telehealth services won’t be satisfied with vague assurances that such care made a difference – they’ll want some basis for analyzing its impact, which can’t be done without at least some basic diagnostic and care-related information. Also, providers will need similar records, for reasons which include the need to integrate the information into the patient’s larger record and to track the progress of this approach.

All of which is to note that I was happy to stumble across an example of a telemedicine provider that’s making efforts to improve its consult notes. While the provider, Doctor on Demand, hasn’t exactly reinvented the telehealth record, it’s improving those records, and to my way of thinking that deserves a shout-out.

As some readers may know, Doctor on Demand is a consumer-facing telemedicine provider which offers video visits with primary care doctors, counselors and psychiatrists. Its competitors include HealthTap and American Well. Because the company works with my health plan, United Healthcare, I’ve used its services to deal with off-hours issues as they arise.

Just today I had a video visit with a Doctor on Demand doctor to address a mild asthma care issue, after which I reviewed the physician’s notes. When I did so, I was happy to see that those notes included a ICD-10 diagnosis code. The notes also incorporated a consumer-level summary of what the diagnosed condition was, what to do about it, what its prognosis was and how to follow up. Essentially, Doctor on Demand’s notes have evolved from a sentence of two of informal suggestions to a more-structured document not unlike a set of hospital discharge instructions.

Don’t get me wrong, I’m certainly well aware that these are just baby steps. Doctor on Demand will have to move a lot further in this direction before consult documentation offers much to other providers. That being said, adding a formal diagnosis code gives the company a better means for analyzing key patterns of utilization internally by presenting condition, which can help its leaders look at whom they serve. Doctor on Demand can also use this information to pitch deals with potential partners, by sharing data on its population and underscoring its capabilities. In other words, these changes should make an impact.

Ultimately, telehealth documentation will have to meet the same expectations that other healthcare documentation does. And it’s not clear to me how freestanding telemedicine firms like Doctor on Demand will bridge that gap. After all, generating complete documentation takes far more than a few useful gestures. Even if the company threw a high-end EMR at the problem, merging it with the existing workflow is likely to be a huge undertaking. But still, making a bit of progress is worthwhile. I hope Doctor on Demand’s competitors are taking similar steps.

E-Patient Update:  Registration Can Add Value To Care 

Posted on August 15, 2016 I Written By

Anne Zieger 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.

For those of you who end up seeking care in hospital emergency departments now and again, the following will probably be familiar. You’re spending the precious few minutes you get with the ED doc discussing your situation, having a test done or asking a nurse some rather personal questions, and a hapless man or woman shows up and inserts themselves into the moment. Why? Because they want to collect registration information.

While these clerks are typically pleasant enough, and their errand relatively brief, their interruption has consequences. In my case, their entry into the room has sometimes caused a nurse or doctor to lose their train of thought, or an explanation in progress was never finished. As if that weren’t irritating enough, the registration clerk – at least at my local community hospital – typically asks questions I’ve already answered previously, or asks me to sign forms I could easily have reviewed at an earlier stage in the process.

Not only that, there have been at least a couple of situations in which a nurse or doctor was so distracted by the clerk’s arrival that some reasonably important issues didn’t get handled. Don’t get me wrong, the skilled team at this facility recovered and addressed these issues before they could escalate, but there’s no guarantee that this will always happen, particularly if the patient isn’t used to keeping track of their care process.

Also, given that alarm fatigue is already leading to patient care mistakes and near-misses, it seems odd that this hospital would squeeze yet another distraction into its ED routine. At least the alarms are intended to serve as clinical decision support and avoid needless errors. Collecting my street address a second time doesn’t rise to that level of importance.

Of course, hospitals need the information the clerk collects, for a variety of legal and operational reasons. I have no problem signing a form giving it permission to bill my insurer, affirming that I don’t need disability accommodations or agreeing to a facility’s “no smoking on campus” policy. And I certainly want any provider that treats me to have full and accurate insurance information, as I obviously don’t want to be billed for the care myself!  But is it really necessary to interrupt a vital care process to accomplish this?

As I see it, verifying registration information could be done much more effectively if it took place at a different point in the sequence of care – at the moment when physicians decide whether to discharge or admit that patient.  After all, if the patient is well enough to answer questions and sign forms while lying in an ED bed, they’re likely to remain so through the admissions process, and verify their financial and personal information once they’re settled (or even while they’re waiting to be transported to their bed). Meanwhile, if the patient is being discharged, they could just as easily provide signatures and personal data as they prepare to leave.

But the above would simply make registration less intrusive. What about adding real value to the process, for both the hospital and the patient? Instead of having a clerk gather this information, why not provide the patient with a tablet which presents the needed information, allowing patients to enter or edit their personal details at leisure.

Then, as they digitally sign off on registration, it would be a great time to ask the patient a few details which help the facility understand the patient’s need for support and care coordination. Why not find out, before the patient is discharged, whether they have a primary care doctor or relevant specialist, whether they can afford their medications, whether they can get to post-discharge visits and the like? This improves results for the patient and ties in with a value-based focus on continuity of care.

These days, it’s not enough just to eliminate pointless workflow disruptions. Let’s leverage the amazing consumer IT platforms we have to make things better!

Modern Day Healthcare Tools and Solutions Can Enhance Your Brand Integrity and Patient Experience

Posted on August 11, 2016 I Written By

The following is a guest blog post by Chelsea Kimbrough, a copywriter for Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Chelsea Kimbrough
Digitally speaking, the healthcare market is more crowded than ever – and finding the perfect provider, practice, or physician online can quickly become an arduous task for even the most tech-savvy patient. But healthcare organizations that dedicate the time, effort, and resources to create a unique digital presence, enhance their search engine optimization (SEO), and reinforce their brand integrity can cut through oversaturated search results to acquire and retain more patients.

In today’s consumer-driven world, shopping for the ideal healthcare organization is quickly becoming the norm. More and more frequently, patients are turning toward the internet during their hunt. In fact, 50 percent of millennials and Gen-Xers used online reviews while last shopping for a healthcare provider. And with 85 percent of adults using the internet and 67 percent using smartphones, accessing this sort of information is easier than ever before.

This ease of access has led patients to adopt more consumer-like behaviors and expectations, such as valuing quality and convenience. Healthcare organizations that proactively ensure their brand image, digital presence, and patient experience cater to these new expectations could be best positioned to thrive. By providing convenient, patient-centric healthcare tools and services, organizations can help facilitate this effort throughout every step of the patient journey.

One such tool is real-time, online appointment self-scheduling, which 77 percent of patients think is important. In addition to adding a degree of convenience for digitally-inclined patients, online self-scheduling tools can support your healthcare organizations’ key initiatives – including driving new, commercially insured patient growth. By using an intuitive way to quickly schedule an appointment, potential patients’ shopping process can be halted in its tracks, ensuring more patients choose your organization over a competitor’s. And with the right tool, your search rankings and discoverability, or SEO, could be significantly enhanced.

Reaching patients where they are most likely to be reached is another way to improve your brand experience. Like consumers, patients are often connected to their phones – so much so that text messages have a 98 percent open rate. Organizations that leverage automated text, email, and voice reminders can successfully communicate important messages, boost patients’ overall satisfaction and health, and improve appointment and follow-up adherence – ultimately setting themselves apart from competitors.

Other digital tools, technologies, and communication strategies can help fortify your brand’s digital standing and patients’ satisfaction, including social media outreach, useful email campaigns, and more. Whatever method – or methods – best serve your organization, it’s important they help improve your SEO, enhance patients’ overall accessibility and experience, and support your brand values and initiatives.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

ONC Announces Winners Of FHIR App Challenge

Posted on August 3, 2016 I Written By

Anne Zieger 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.

The ONC has announced the first wave of winners of two app challenges, both of which called for competitors to use FHIR standards and open APIs.

As I’ve noted previously, I’m skeptical that market forces can solve our industry’s broad interoperability problems, even if they’re supported and channeled by a neutral intermediary like ONC. But there’s little doubt that FHIR has the potential to provide some of the benefits of interoperability, as we’ll see below.

Winners of Phase 1 of the agency’s Consumer Health Data Aggregator Challenge, each of whom will receive a $15,000 award, included the following:

  • Green Circle Health’s platform is designed to provide a comprehensive family health dashboard covering the Common Clinical Data Set, using FHIR to transfer patient information. This app will also integrate patient-generated health data from connected devices such as wearables and sensors.
  • The Prevvy Family Health Assistant by HealthCentrix offers tools for managing a family’s health and wellness, as well as targeted data exchange. Prevvy uses both FHIR and Direct messaging with EMRs certified for Meaningful Use Stage 2.
  • Medyear’s mobile app uses FHIR to merge patient records from multiple sources, making them accessible through a single interface. It displays real-time EMR updates via a social media-style feed, as well as functions intended to make it simple to message or call clinicians.
  • The Locket app by MetroStar Systems pulls patient data from different EMRs together onto a single mobile device. Other Locket capabilities include paper-free check in and appointment scheduling and reminders.

ONC also announced winners of the Provider User Experience Challenge, each of whom will also get a $15,000 award. This part of the contest was dedicated to promoting the use of FHIR as well, but participants were asked to show how they could enhance providers’ EMR experience, specifically by making clinical workflows more intuitive, specific to clinical specialty and actionable, by making data accessible to apps through APIs. Winners include the following:

  • The Herald platform by Herald Health uses FHIR to highlight patient information most needed by clinicians. By integrating FHIT, Herald will offer alerts based on real-time EMR data.
  • PHRASE (Population Health Risk Assessment Support Engine) Health is creating a clinical decision support platform designed to better manage emerging illnesses, integrating more external data sources into the process of identifying at-risk patients and enabling the two-way exchange of information between providers and public health entities.
  • A partnership between the University of Utah Health Care, Intermountain Healthcare and Duke Health System is providing clinical decision support for timely diagnosis and management of newborn bilirubin according to evidence-based practice. The partners will integrate the app across each member’s EMR.
  • WellSheet has created a web application using machine learning and natural language processing to prioritize important information during a patient visit. Its algorithm simplifies workflows incorporating multiple data sources, including those enabled by FHIR. It then presents information in a single screen.

As I see it, the two contests don’t necessarily need to be run on separate tracks. After all, providers need aggregate data and consumers need prioritized, easy-to-navigate platforms. But either way, this effort seems to have been productive. I’m eager to see the winners of the next phase.

Do We Underestimate the Power of Smart Phones in Healthcare? – Fun Friday

Posted on July 29, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Smart phones have become a serious societal addiction. In some ways that is bad and no doubt there are plenty of studies that will come out about the negative impacts from cell phone addiction. However, the fact that people always have their cell phone is also a tremendous opportunity for healthcare to really engage their patient. This is what came to mind when I saw these funny cartoons about our addiction to our cell phones.

Cell Phone Addiction - Social Science Research Cartoon

Cell Phone Addiction Cartoon

Thanks Eric Topol for sharing these cartoons.

Has Technology Changed The Way We Interact With Each Other, Our Healthcare Providers And Healthcare Organizations?

Posted on July 19, 2016 I Written By

The following is a guest blog post by Brittany Quemby,  Marketing Manager of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle

In this blog series, we have talked a lot about healthcare consumerism, the importance of communication in the patient/provider relationship and how embracing technology can lead to an increased patient experience. Today I want to talk about how technology is changing the way we interact with each other in the healthcare industry.

The other day I tried to book a doctor’s appointment with my family physician.  I looked up my family physician’s phone number online and called in. After about 25 rings, 20 minutes on hold and a cranky voice on the other end, I hung up the phone feeling extremely frustrated and couldn’t event remember the time of my appointment.

This left me thinking. Everyday we rely and crave the use of technology to help us be more efficient and to simplify our lives.  I would argue, even more so, when it comes to our health. Approximately 58% of patients believe that technology leads to better care.  Technology has truly transformed the way patients want to interact with providers.  And to be fair, a lot of healthcare organizations and clinicians have been quick to adopt as they see the efficiency and patient experience benefits – so what was the hold up with my family physician?  I think perhaps they just weren’t aware of the facts.

So let’s take a look at them:

Fact 1 – Mobile Health

The truth hurts.  Many of us are addicted to our phone and are guilty of driving home when we were almost at work to retrieve it. When it comes to mobile health, the addiction is just as strong. Over 50% of smartphone owners, have used their phone to look up health or medical information.  A staggering 80% of patients want the option of using their smartphone to interact with healthcare providers.  Traditional methods of inquiring about our health and interacting with healthcare providers are long gone. Today’s technology makes it much more convenient for both physicians and patients to connect, research and communicate right from their smartphone.

Fact 2 – Online Health

Face it! Most of us have gone down the rabbit hole of searching a particular ailment online.  At least 35% of U.S. adults say they have gone online to try to figure out what medical condition they or someone else might have. Research indicates that 77% of online health seekers began their last session at a search engine such as Google, Bing, or Yahoo.  The presence of the internet has given patients easy access to information and has empowered them to make more informed choices about their health. It has also allowed physicians to easily update new information and build interactive treatment plans that can increase patient adherence and retention.

Fact 3 – Online Scheduling

Truth be told, I did scream when I got off the phone with doctor’s office.  Why was calling in to book my doctor’s appointment the most painful thing I had done all week? I am not alone, 77% of consumers think that the ability to book, change or cancel healthcare appointments online is important. Technology has us conditioned to want the quickest and easiest way of getting things done.  It is much quicker and convenient to go online to book the next available appointment than the 8.1 minutes it takes for a patient to complete a scheduling call.  Online scheduling helps to satisfy a patient’s need for quick gratification and alleviates the significant amount of time staff spend scheduling appointments.

Fact 4 – Digital Communication Platforms

The fact that I couldn’t remember the time of my appointment the moment I got off the phone was a bit embarrassing. But let’s face it, we’ve become so reliant on technology telling us where we need to be and what time we need to be there that our brains begin to ignore certain timelines. The truth is, the sticky note no longer holds the top spot in patient’s minds. A whopping 85% of consumers say that they would welcome digital appointment reminders, medication reminders and general health tips.   This type of technology is a win-win for both patients and clinicians.  Patients receive a simple reminder that can be added into their calendar allowing them to show up and be better prepared and clinicians receive appointment confirmations allowing them to increase their operational efficiencies, revenue and better manage their daily schedule.

Fact 5 – Tracking Health

Tracking health is not a new concept, but the exchanges and the method patients are tracking their health has revolutionized with newer technology. When recommended by a doctor, 3 in 4 consumers followed advice to wear technology to track their health. Over 20% of patients track their health indicators with the use of technology.  Technologies that assist in tracking one’s health have allowed for higher patient engagement which can lead to better monitoring and increased outcomes.  Both US consumers (77%) and doctors (85%) agree that using wearables helps a patient engage in their own health.

As technology evolves, so will our interactions as patients, providers and healthcare organizations.   It’s imperative to capitalize on the many benefits healthcare technology has given us to ensure we expand our connectivity, grow our data, increase our health outcomes and continuously improve our communication and collaboration. However, and unfortunately, in the meantime while we wait for everyone to catch up some of us will suffer from the frustration of expecting technology and not getting it. #Siricantyoujustrunmylife

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

An Alternate Way Of Authenticating Patients

Posted on July 5, 2016 I Written By

Anne Zieger 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.

Lately, I’ve been experimenting with a security app I downloaded to my Android phone. The app, True Key by Intel Security, allows you to log in by presenting your face for a scan or using your fingerprint. Once inside the app, you can access your preferred apps with a single click, as it stores your user name and passwords securely. Next, I simplified things further by downloading the app to my laptop and tablet, which synchs up whatever access info I enter across all devices.

From what I can see, Intel is positioning this as a direct-to-consumer play. The True Key documentation describes the app as a tool non-techies can use to access sites easily, store passwords securely and visit their favorite sites across all of their devices without re-entering authentication data. But I’m intrigued by the app’s potential for enterprise healthcare security access control.

Right now, there are serious flaws in the way application access is managed. As things stand, authentication information is usually stored in the same network infrastructure as the applications themselves, at least on a high-level basis. So the process goes like this, more or less: Untrusted device uses untrusted app to access a secure system. The secure system requests credentials from the device user, verifies them against an ID/PW database and if they are correct, logs them in.

Of course, there are alternatives to this approach, ranging from biometric-only access and instantly-generated, always-unique passwords, but few organizations have the resources to maintain super-advanced access protocols. So in reality, most enterprises have to firewall up their security and authentication databases and pray that those resources don’t get hacked. Theoretically, institutions might be able to create another hacking speed bump by storing authentication information in the cloud, but that obviously raises a host of additional security questions.

So here’s an idea. What if health IT organizations demanded that users install biometrically-locked apps like True Key on their devices? Then, enterprise HIT software could authenticate users at the device level – surely a possibility given that devices have unique IDs – and let users maintain password security at their end. That way, if an enterprise system was hacked, the attacker could gain access to device information, but wouldn’t have immediate access to a massive ID and PW database that gave them access to all system resources.

What I’m getting at, here, is that I believe healthcare organizations should maintain relationships with patients (as represented by their unique devices) rather than their ID and password. While no form of identity verification is perfect, to me it seems a lot more like that it’s really me logging in if I had to use my facial features or fingerprint as an entry point. After all, virtually any ID/PW pair chosen by a user can be guessed or hacked, but if you authenticate to my face/fingerprint and a registered device, the odds are high that you’re getting me.

So now it’s your turn, readers. What flaws do you see in this approach? Have you run into other apps that might serve this purpose better than True Key? Should HIT vendors create these apps? Have at it.

What If Your Doctor Knew All Your Health Searches?

Posted on June 30, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Back in 2013, the Pew Research Internet Project found that 72% of internet users looked online for health information. This was well before the most recent update to Dr. Google. It’s only a matter of time that those health searches will end up going through some sort of AI solution (Siri, Alexa, Galaxy, etc) we bring into the home.

Imagine if we connected this font of health information and questions together with the healthcare establishment. What if your doctor had access to all of the health related searches you were doing? Might he be able to provide better service to you and your family?

Yes, I realize that this idea will be extremely controversial. There are some major privacy challenges and issues with this idea, but there’s also a lot of potential benefits. It seems a little bit hypocritical that we ask doctors to be open and transparent with our health records if we as patients aren’t going to be open and transparent with our medical concerns. Certainly, we should be able to control what and with whom we share this information, but I believe that many will be willing to share it with their doctors.

Yes, this will require a pretty dramatic shift in how our medical professionals will handle a patient visit. However, if I’ve been doing a bunch of searches around back pain, imagine how much different my visit to the doctor for an earache would be. Could that provide the opportunity for the doctor to talk to me about my back pain searches?

It’s fascinating to think how this is almost the complete opposite of the office visit today. I’ve seen doctors that wanted to only deal with one issue at a time. Those doctors have learned the special dance that allows them to avoid talking about more than the presenting concern. Many doctors learn essentially a new language that makes sure that they get in and out of the exam room quickly without bringing up the rabbit hole of potential health problems a patient might be actually experiencing.

That’s the reality of today’s medicine. This is what we pay them to do. That’s changing with things like CCM where a healthcare provider is paid to dig in a little deeper. It’s certainly not enough to fully change these behaviors.

Until the reimbursement fully changes over to doctors getting paid to keep you healthy, a doctor knowing your health searches won’t be of interest to most doctors. However, once reimbursement changes, a doctor will become much more interested in what’s really ailing you. Your online searches certainly will say a lot about your health, both physical and mental.

AMA’s Digital Health ‘Snake Oil’ Claim Creates Needless Conflict

Posted on June 22, 2016 I Written By

Anne Zieger 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.

Earlier this month, the head of the American Medical Association issued a challenge which should resonate for years to come. At this year’s annual meeting, Dr. James Madara argued that many direct-to-consumer digital health products, apps and even EMRs were “the digital snake oil of the early 21st century,” and that doctors will need to serve as gatekeepers to the industry.

His comments, which have been controversial, weren’t quite as immoderate as some critics have suggested. He argued that some digital health tools were “potentially magnificent,” and called on doctors to separate useful products from “so-called advancements that don’t have an appropriate evidence base, or that just don’t work that well – or that actually impede care, confuse patients, and waste our time.”

It certainly makes sense to sort the digital wheat from the chaff. After all, as of late last year there were more than 165,000 mobile health apps on the market, more than double that available in 2013, according to a study by IMS Institute for Healthcare Informatics. And despite the increasing proliferation of wearable health trackers, there is little research available to suggest that they offer concrete health benefits or promote sustainable behavior change.

That being said, the term “snake oil” has a loaded historical meaning, and we should hold Dr. Madara accountable for using it. According to Wikipedia, “snake oil” is an expression associated with products that offer questionable or unverifiable quality or benefits – which may or may not be fair. But let’s take things a bit further. In the same entry, Wikipedia defines a snake oil salesman “is someone who knowingly sells fraudulent goods or who is themselves a fraud, quack or charlatan.” And that’s a pretty harsh way to describe digital health entrepreneurs.

Ultimately, though, the issue isn’t whether Dr. Madara hurt someone’s feelings. What troubles me about his comments is they create conflict where none needs to exist.

Back in the 1850s, when what can charitably be called “entrepreneurs” were selling useless or toxic elixirs, many were doubtless aware that the products they sold had no benefit or might even harm consumers. And if what I’ve read about that era is true, I doubt they cared.

But today’s digital health entrepreneurs, in contrast, desperately want to get it right. These innovators – and digital health product line leaders within firms like Samsung and Apple – are very open to working with clinicians. In fact, most if not all work directly with both staff doctors and clinicians in community practice, and are always open to getting guidance on how to support the practice of medicine.

So while Dr. Madara’s comments aren’t precisely wrong, they suggest a fear and distrust of technology which doesn’t become any 21st century professional organization.

Think I’m wrong? Well, then why didn’t the AMA leader announce the formation of an investment fund to back the “potentially magnificent” advances he admits exist? If the AMA did that, it would demonstrate that even a 169-year-old organization can adapt and grow. But otherwise, his words suggest that the venerable trade group still holds disappointingly Luddite views better suited for the dustbin of history.

UPDATE:  An AMA representative has informed me that I got some details in the story above wrong, and I’m eager to correct my error. According to Christopher Khoury, vice president of environmental analysis and strategic analytics with the group, the AMA is indeed investing in digital health innovation. He notes that in January, the group announced the formation of San Francisco-based Health2047 (www.health2047.com), for which it serves as lead investor. Health2047 is dedicated to furthering the commercialization of digital tools and solutions that help practicing physicians. It also sponsors Matter, a healthcare incubator based in Chicago.