Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

The Required Shift in How Patients View Wearables

Posted on September 27, 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.

This post is sponsored by Samsung Business. All thoughts and opinions are my own.

We’ve all seen the explosive growth that’s occurred in the wearables market. The most extraordinary part of the wearables explosion is that the majority of wearables growth has been in the healthcare space. The problem we now see in healthcare is that most people don’t look at wearables as a disease management tool as much as they see them as lifestyle tools. This was described really well by Megan Williams on the Samsung Insights blog:

Perhaps the most challenging part of meeting that desire [Physician Access to Patients’ Lives and Health] is the fact that patients mostly view wearables as an aid in lifestyle improvement instead of disease management. The task of helping patients understand that wearables are about much more than weight loss will fall squarely on the shoulders of providers.

Patients have traditionally shown a preference for lifestyle apps including fitness, nutrition and heart rate aids, and have been much slower to adopt disease management tools, even as chronic disease remains a burden on healthcare as a whole. Encouraging the use of a broader range of wearables, digital tools and apps will be a challenge for any provider.

Changing habits and perceptions is always a challenge. However, it’s also a great opportunity.

No one would argue that today’s wearables are more than novelty items that may have some impact on your lifestyle (fitness, nutrition, etc). That’s largely because the initial wearables were designed around those retail areas of the market. It’s much easier to create a retail wearable device than to create a disease management focused healthcare device.

As the healthcare wearables market matures so will patients expectations around the benefits they can receive from those wearables. I think there are two main keys to development of wearables as true healthcare devices: Depth of Tracking and Connection to Providers.

Depth of Tracking
I’ve argued for a while now that all the various fitness trackers were not clinically relevant. I still believe that today, but I also believe that wearables like the various fitness trackers will start tracking us in ways that are clinically relevant. That just takes a lot longer to develop.

Whether it’s new trackers that screen for sleep apnea or ECGs that monitor our heart, we’re seeing more and more wearable devices monitoring data that’s more clinically relevant than the number of steps you’ve taken. This trend will continue. As wearables more deeply track various parts of the human body, the opportunities to understand your health and improve your health will follow along with it. This will provide doctors the impetus to request access to your wearable data.

The deep data these wearables will provide will challenge the tried and true beliefs healthcare holds so dearly today. That can be scary for some, but is also very exciting.

Connection to Providers
While wearables will provide the data, we’ll still want to consult a healthcare provider to understand the data and to create a plan of action based on that data. At least in the foreseeable future, our health will depend on collaboration with healthcare providers as opposed to a replacement of healthcare providers. This will be particularly true as the type of data our wearables collect gets more complicated. Understanding your step chart is quite different than understanding your ECG.

In order to facilitate this collaboration, our wearables will have to be connected to our care providers. Note that I said care providers and not doctors. In some cases it might be our doctor, but in other cases it could be a nurse, care manager, social worker, or some other care provider. I’m hopeful that we eventually reach the point of a true care team that collaborates on our health. That’s a far cry from where most of our healthcare is today, but that is the hope.

If we can solve these two wearable challenges: Deeper Data and Connected Providers, then we’ll be well on our way to changing how patients view wearables. This shift won’t happen over night, but I believe it will happen a lot quicker than most people imagine.

For more content like this, follow Samsung on Insights, Twitter, LinkedIn , YouTube and SlideShare.

Health Data: Little White Lie Detector

Posted on December 31, 2012 I Written By

Mandi Bishop is a hardcore health data geek with a Master's in English and a passion for big data analytics, which she brings to her role as Dell Health’s Analytics Solutions Lead. She fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

As we bring 2012 to a close and ponder the new year ahead, many of us make resolutions to change something in our lives, and frequently, that something is our health. According to the University of Scranton Journal of Psychology, 47% of Americans make New Years Resolutions. Of those, the #1 New Years Resolution for 2012 is to lose weight. Staying fit and healthy and quitting smoking also appear in the top 10. Each of these health-related resolutions translates into quantifiable healthcare data that is, or can be, captured and measured to assist the resolution-makers in achieving their goals. Our calorie consumption and burn can be calculated, our blood oxygen level monitored, our ratio of fat:lean muscle mass tracked over time. If only we were all a bit more like George Washington, and couldn’t tell a lie, the success rate for annual resolutions would be higher than 8%.

The inclination to tell little white lies to protect ourselves from inconvenient, uncomfortable truths exists in all of us. “Do these jeans make my butt look fat,” meets, “Of course not,” rather than, “Yes, your butt DOES look fat in those jeans – but it’s not the jeans’ fault.” “Can Timmy come play,” warrants, “We already have plans – let’s rain check,” in lieu of, “Your child is a brat who cannot enter my home because I prefer to keep all my hair rooted in my scalp.”

Many, if not most, of us extend these white lies to ourselves. The dress that fit last month but doesn’t today “shrunk at the dry cleaner”. Cigarettes only smoked during cocktail hour don’t really count as “smoking”. You count the time you spend standing to give office presentations as “exercise”. You “usually” eat healthy, except for the tell-tale McDonald’s bags in your garbage showing a once-a-day burger and fries habit.

What if there were a way to identify and hold you accountable for these self-delusions – a health data lie detector? Would you change your behavior? Could you achieve your healthy resolution? And might it have a quantifiable impact on healthcare cost if you did?

I had a partial thyroidectomy a few years ago. A year after my surgery, I found I had gained 7 pounds in 11 days, was feeling lethargic and was having difficulty sleeping. As a very active adult who meticulously maintained body weight for a decade, I was disturbed, and convinced that my symptoms were a result of my remaining thyroid tissue failing. I went to my primary care physician to request a hormone test.

The nurse and doctor both agreed that, in 90% of cases, the root cause of weight gain is diet, and they asked myriad questions, capturing all my answers in the clinical notes of their EMR: had I been eating differently, had I altered my exercise routine, had I been traveling. I was adamant that nothing had drastically changed. Given my fitness and history, they agreed to order the hormone test, and a blood vitamin test, as well.

All lab work came back normal. BETTER than normal. So I retraced every detail of my routine over those 11 days. And I discovered the culprit: office candy.

A bad meeting one day led to grabbing a handful of chocolates from one co-workers bowl, which became grabbing a handful of chocolates from each bowl I encountered on my department’s floor…several times a day. Did you know there are 35 calories in a single Hershey’s kiss? 220 calories in a handful of peanut M&Ms? 96 calories in a mini-Butterfinger bar? Turns out, I was eating between 500-700 calories a day in office candy. And that wasn’t all.

Along with the chocolate snacks, I’d fallen into some poor nutrition habits at meals. I started to consume other starchy carbs regularly: the pre-dinner bread basket at restaurants, pizza, pasta, sandwich bread. I didn’t feel I ate to excess, but I also didn’t take into account the difference in nutrient density between the mass quantities of fruits and vegetables I had been eating for years, and the smaller (yet still plentiful) quantities of processed starches I was currently eating.

The changes in diet likely disturbed my sleeping pattern and led to my lethargy, which in turn made my daily workouts less intense and effective at calorie-burning.

In short, my weight gain was legit, and the two doctor visits and the lab tests could have been avoided had I been completely honest with myself. I cost each actor in the healthcare system money with my self-deluding little white lie: the office administrative staff, the LRNP, the doctor, the medical coder, the lab, the insurance company, myself. There is also a per-transaction cost associated with each HIPAA-covered request that the doctors’ office EMR and lab information system generated. Given that I have only been to the doctor three times this year, and twice was for this weight gain concern, one could accurately conclude that 66% of my annual medical costs could have been avoided in 2012.

The health data exists within Meaningful Use-certified EMR systems to capture and communicate both the absolute data (height, weight, lab results, etc.) and the unstructured notes data (patient comments, doctor notes, responses to questionnaires, etc.). The capability to automatically compare the absolute with the unstructured data already exists. It wouldn’t take an inordinate amount of effort to program a lie detector to call out many of the most common little white lies.

What would happen to medical cost if we stopped lying to ourselves, and to our healthcare providers? And how high a percentage of the nation’s total healthcare bill could be avoided by this type of analysis? Better still, how much would the healthcare industry change if patients not only took responsibility for their own action/inaction, but modified their behaviors accordingly?

I’ll tell you what happened to me. I dropped the candy and starchy carbs, and I lost those 7 pounds. Keeping them off will be 2013’s New Years Resolution.

9 Ways IT is Transforming Healthcare – “Top 10” Health IT List Series

Posted on December 27, 2011 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.

As is often common at the end of the year, a lot of companies have started putting together their “Top 10” (or some similar number) lists for 2011. In fact, some of them have posted these lists a little bit earlier than usual. This week as people are often off work or on vacation, I thought it might be fun to take one list each day and comment on the various items people have on their lists.

The first list comes from Booz Allen Hamilton and is Booz Allen’s Top 9 ways IT is Transforming healthcare. Here’s their list of 9 items with my own commentary after each item.

Reduces medical errors. I prefer to say that Health IT has the potential to reduce medical errors. I also think long term that health IT and EMR will reduce medical errors. However, in the interim it will depend on how people actually use these systems. Used improperly, it can actually cause more medical errors. There have been studies out that show both an improvement in medical errors and an increase in medical errors.

My take on this is that EMR and health IT improves certain areas and hurts other areas. However, as we improve these systems and use of these systems, then over all medical errors will go down. However, remember that even once these systems are perfect they’re still going to be run be imperfect humans that are just trying to do their best (at least most of them). Even so, long term health IT and EMR software will be something that will benefit healthcare as far as reducing medical errors.

Improves collaboration throughout the health care system. I’m a little torn as we consider whether health IT improves collaboration. The biggest argument you can make for this is that it’s really hard to be truly interoperable in really meaningful and quick ways without technology. Sure, we’ve been able to fax over medical records which no one would doubt has improved health care. However, those faxes often get their too late since they take time to process. Technology will be the solution to solving this problem.

The real conundrum here is the value that could be achieved by sending specific data. A fax is basically a mass of data which can’t be processed by a computer in any meaningful way. How much nicer would it be to have an allergy passed from one system to another. No request for information was made. No waiting for a response from a medical records department. Just a notification on the new doctor’s screen that the patient is allergic to something or is taking a drug that might have contraindications with the one the new doctor is trying to prescribe. This sort of seamless exchange of data is where we should and could be if it weren’t for data silos and economics.

Ensures better patient-care transition. This year there was a whole conference dedicated to this idea. No doubt there is merit in what’s possible. The problems here are similar to those mentioned above in the care collaboration section. Sadly, the technology is there and ready to be deployed. It’s connecting the bureaucratic and financial dots to make it a reality.

Enables faster, better emergency care. I’m not sure why, but the emergency room gets lots of interesting technology that no one else in healthcare gets. I imagine it’s because emergency rooms can easily argue that they’re a little bit “different” from the rest of the hospital and so they are able to often embark on neat technology projects without the weight of the whole hospital around their neck.

One of the technologies I love in emergency care is connecting the emergency rooms with the ambulances. There are so many cool options out there and with 3G finally coming into its own, connectivity isn’t nearly the problem that it use to be. Plus, there are even consumer apps like MyCrisisRecords that are trying to make an in road in emergency care. I’d like to see broader adoption of these apps in emergency rooms, but you can see the promise.

Empowers patients and their families to participate in care decisions. Many might argue that with Google Health Failing and Microsoft HealthVault not making much noise, that the idea of empowering patients might not be as strong. Turns out that the reality is quite the opposite.

Patients and families are participating more and more in care decisions. There just isn’t one dominant market leader that facilitates this interaction. Patients and families are using an amalgamation of technologies and the all powerful Google to participate in their care. This trend will continue to become more popular. We’ll see if any company can really capture the energy of this movement in a way that they become the dominant market leader or whether it will remain a really fluid environment.

Makes care more convenient for patients. I believe we’re starting to see the inklings of this happening. At the core of this for me is patient online scheduling and patient online visits. Maybe it could more simply be identified as: patient communication with providers.

I don’t think 2011 has been the watershed year for convenient access to doctors by patients. However, we’re starting to see inroads made which will open up the doors for the flood of patients that want to have these types of interactions.

Helps care for the warfighter. This is an area where I also don’t have a lot of experience. Although, I do remember one visit with someone from the Army at a conference. In that short chat we had, he talked about all the issues the Army had been dealing with for decades: patient record standards, patient identifiers, multiple locations (see Iraq and Afghanistan), multiple systems, etc. The problem he identified was that much of it was classified and so it couldn’t be shared. I hope health IT does help our warriors. It should!

Enhances ability to respond to public health emergencies and disasters. I’ve been to quite a few presentations where people have talked about the benefits and challenges associated with electronic medical records and natural disasters. They’ve always been really insightful since they almost always have 5-6 “I hadn’t thought of that” moments that make you realize that we’re not as secure and prepared for disasters as we think we are.

It is worth noting that moving 100,000 patient records electronically to an off site location is much easier in the electronic world than it is in paper. With paper charts we can’t even really discuss the idea of remote access to the record in the case of a natural disaster.

Possibly even more interesting is the idea of EMR and health IT supporting public health emergencies. We’re just beginning to aggregate health data from EMR software that could help us identify and mitigate the impact of a public health emergency. Certainly none of these systems are going to be perfect. Many of these systems are going to miss things we wish they’d seen. However, there’s real potential benefit in them helping is identify public health emergencies before they become catastrophes.

Enables discovery in new medical breakthroughs and provides a platform for innovation. Most of the medical breakthroughs we’ve experienced in the last 20 years would likely have been impossible without technology. Plus, I don’t think we’ve even started to tap the power that could be available from the mounds of healthcare data that we have available to us. This is why I’m so excited about the Health.Data.Gov health data sharing program that Priya wrote about on EMR and EHR. There’s so many more medical discoveries that will be facilitated by healthcare data.

There you have it. What do you think of these 9 items? Are there other things that you see happening that will impact the above items? Are there trends that we should be watching in health IT in 2012?

Be sure to read the rest of my Health IT Top 10 as they’re posted.

Compelling Case for Personal Health Records (PHR)

Posted on March 4, 2011 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.

I recently read an article (which I can’t find now) that said, We don’t log in to check our health data as much as we do our financial data. This was a pretty interesting statement considering a few days back I posted this tweet about PHR and being an active patient:

Figuring out the right motivation for someone to use a PHR has been something that’s been on my mind for quite a while. You may remember my post about requesting an appointment and sending your medical record using a PHR where I was asking some similar questions.

There’s certainly a place for software that connects patients with their doctors for things like scheduling an appointment, paying their bills, requesting prescription refills, and even doing e-visits. In fact, one of my advertisers recently launched an enterprise patient portal that has these types of features (check out this video which describes their feature set).

There’s no arguing that these types of connections to doctors are valued and something that patients would love to have. Many doctors are still on the fence about them, but I’m sure we’ll be seeing more and more of these types of services over time. However, while being really great features they still don’t solve the problem of a healthy patient wanting to log in to this portal regularly.

I think one game changer when it comes to PHR will likely be around an emerging set of devices which track our health. For example, over on Smart Phone Healthcare I recently wrote about Tracking Fitness and Activity Levels on Your Smartphone. These devices will track your steps, calories, heart rate, and sleep data and upload it to a centralized location where you can see all that data and watch your fitness and activity levels change over time. Plus, I believe we’re just getting started with collecting this type of data. You can easily see this moving to blood sugar levels, cholesterol, blood pressure, etc.

Now imagine that all of this data was available in your PHR. This type of data would be constantly updated and seeing the graphs of this health data over time is something that I’d login to check as much as I do my financial data.

Previously, I’d always been a bit down on these types of tracking devices. I’ve argued that we’re missing that link for doctors to be able to do something with the data that patients are collecting. I still think this is the case, but just because your doctor might not use the data a patient collects doesn’t mean it can’t be valuable to the patient to collect and see that data regularly. Plus, once EHR software and doctors are ready to digest the data, you’ll be ready as well.