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Fujitsu Smartphone to Measure Vitals

Posted on April 10, 2013 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.

There’s a revolution in health sensors that are coming to the smartphone world. This was first seen when the Samsung phones decided to include sensors to measure the temperature and humidity of your location.

It looks like Fujitsu is ready to launch a new smartphone that measures your vital health information using you smartphone camera. Here’s an excerpt from the article:

[Fujitsu] have just announced plan to begin including health tracking technology into their future smartphones. This tech would be able to figure out your heart rate just by looking at your face. Basically, you stick your mug in front of the camera and the phone does the rest. How in the world does it do this? Subtle changes in facial blood flow are not detectable by the human eye but are able to be seen by computers. Lo and behold, smartphones are actually computers.

I first saw this technology in action at the Connected Health Summit in Boston a couple years ago. It’s really amazing monitoring technology using just your smartphone camera. It’s a beautiful thing since you don’t need a wristband, armband, clip on, etc. You just need the smartphone that you’re carrying around already.

I wonder if this monitoring technology is just an app that can work with almost any hardware or if it will need a specific camera to work right. It would be great if it’s just an app, because then this could work for any smartphone.

The Problem I See with Home Health Monitoring

Posted on April 27, 2012 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.

When I was writing my post about this mHealth infographic, the thought came to me about why I’ve never felt truly comfortable with the idea of Home Health Monitoring (some might call it the Patient Centered Medical Home). I think the problem I see lies in our ambitious goals of what we monitor at home.

As I said a bit in the linked posts, many doctors love the idea of a patient tracking their health information, but their also extremely scared about how they’re going to deal with all of the data coming at them. There are exceptions to this rule, but most doctors don’t usually get a whole bunch of data a patients collected that they have to incorporate into the visit. Sure, a physician treating diabetes will often get a stack of food journals and blood sugar levels. However, most doctors are trained to get the data they need on their own.

I believe this is the real challenge with home health monitoring. In far too many cases I’ve seen mHealth apps that are trying to monitor too much data. Sure, I think it’s great to be ambitious and I think it’s even better to collect as much data as we can. Long term I think that patient collected healthcare data is going to be essential to providing great healthcare. Although, in the short term if we want to break most physicians into Home Health Monitoring, then I think we need to be a little less ambitious and more targeted.

The post mentioned above highlights some things that I don’t think any doctors would be overwhelmed with if they received this information: weight, blood sugar, and vital signs. I’m sure we could add to this list, but a lot can be learned from just these elements. Sure, bringing in full on food journals, sleep data, walking data, exercise data, EKG data, etc etc etc could be useful to a doctor. However, in our current state if you bring all of that data to the doctor you’re likely going to overwhelm them and they won’t know what to do.

I can’t wait for the day we have Smart EMR software that can take the volume of patient collected data and make it actionable for the doctor. Unfortunately, we’re not there yet. Until then, maybe we need to focus our Home Health Monitoring into bit size chunks that doctors can easily digest and actually use.

They Do Listen: Stage 2 Proposal Includes Some Changes to Stage 1 – Meaningful Use Monday

Posted on April 9, 2012 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Included in the Proposed Rule for Meaningful Use Stage 2 are several modifications to the requirements for Meaningful Use Stage 1—likely in response to a barrage of comments from providers. 

The MU Stage 1 measure requiring a test of the ability to exchange clinical data would be removed effective 2013. Apparently, the concept of a test created a great deal of confusion. This change, however, should not be interpreted as reduced interest in interoperability. In fact, Stage 2 is all about the sharing of data. The measure would be replaced in Stage 2 by numerous other measures that require the sharing of clinical information—both between providers and with patients. 

The “all 3 vital signs dilemma”, (described in a previous Meaningful Use Monday post), would be resolved by a change to the vital signs measure. Separating height and weight from blood pressure, the revised measure would allow a provider to meet the threshold for recording height and weight, while claiming an exclusion for blood pressure, (or vice-versa). This is good news for specialists like orthopaedists who may routinely document height and weight but who rarely document blood pressure unless it is relevant to a specific patient’s problem. This change would be available as an option in 2013, and formalized in 2014. (The vital signs measure would also increase the minimum age requiring blood pressure documentation from 2-year olds to 3-year olds.) 

Many providers reported a problem in meeting the CPOE measure because of the way the calculation was defined—particularly those providers whose treatment does not frequently include prescribing medication. Now, providers would be able to define the denominator as the number of medications ordered, rather than the “number of unique patients with at least one medication in the patient’s medication list”, (since that list often includes medications downloaded from Surescripts and prescribed by other providers.) There is already a CMS FAQ (#10369) that allows providers to use this alternate definition even in 2012.

The government is listening, so make your voice heard. Use your experience in Meaningful Use Stage 1 to influence Meaningful Use Stage 2. Submit your comments on the Proposed Rule for Stage 2.

Meaningful Use Measures:  More on Recording Vital Signs – Meaningful Use Monday

Posted on May 9, 2011 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

To follow up on The “All 3” Vital Signs Dilemma and the posted comments, I want to provide some clarification regarding the vital signs measure and correct some common misconceptions about the requirements: 

Meaningful Use Core Measure: Record Vital Signs
For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data. 

  1. The Exclusion: A physician who does not currently track height, weight, and blood pressure does not have to start taking vital signs solely for the purpose of meeting meaningful use. The point I made in last week’s post was that the exclusion may be difficult for some providers to take advantage of due to the “all 3” requirement—but it is available for those who attest that “all 3 vital signs have no relevance to their scope of practice.” A psychiatrist, for example, could likely attest to this exclusion; and the exclusion would satisfy the measure. 
  2. The physician (or staff) does not have to record the vital signs at each patient visit. It is up to the physician’s discretion how frequently—on a patient-by-patient basis—this clinical information should be updated.  
  3. In fact, the measure does not even require that the data be entered during the reporting period. It only requires that the vital signs be in the EHR charts (of 50%) of the patients who were seen during the reporting period. This means that the data could already be there from a past visit—even a visit that occurred prior to the reporting period. 
  4. The physician (or staff) does not have to be the source of the vital signs data. It can come from another provider or directly from the patient—electronically, on paper, entered through a portal, or in any other way. 

Regarding last week’s comments….I wholeheartedly agree that meaningful use should not be the predominant reason for a provider to adopt an EHR. An EHR should be implemented based on of its ability to deliver benefits related to practice efficiency, physician productivity, and quality of care. With the right EHR, these benefits will far exceed the potential $44,000 incentives.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Meaningful Use Measures: The “All 3” Vital Signs Dilemma – Meaningful Use Monday

Posted on May 2, 2011 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

How does a physician meet this measure if only one or two, but not all three, of the vital signs are a routine part of their practice? This is an issue on which I have sought clarification since before my first Meaningful Use Monday post.  The question has now been asked frequently enough to warrant a formal answer on the CMS FAQ site—and the answer is problematic.

Meaningful Use Core Measure: Record Vital Signs
For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data.
Exclusion: Any EP who either sees no patients 2 years or older or who believes that all 3 vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice.

You’d think this measure would be pretty straightforward—and it is, for primary-care physicians (and some specialists), for whom taking vital signs is a given. Other specialists, such as dermatologists, ophthalmologists, and psychiatrists, will likely attest that (all 3) vital signs are not a routine part of their practice, and they will meet the measure by attesting to an exclusion.

But how will other specialists meet and report on this measure? Some orthopaedists, for example, routinely* record height and weight, but few take blood pressure, (recording it only when documented—typically by the patient’s primary-care physician—for surgical clearance). ENT specialists may routinely* take blood pressure, but don’t record height and weight.

According to FAQ Answer ID# 10593, “If an EP believes that one or two of these vital signs are relevant to their scope of practice, they must record all three in order to meet the measure.” Therefore, specialists like the above have two choices if they want to demonstrate meaningful use:

  • Attest that all 3 vital signs have no relevance to their practice, or
  • Add the missing function(s) to their practice’s workflow, despite the lack of relevance.

I am interested in how physicians facing this dilemma plan to address the vital signs measure.  Please share your comments below.

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*Note:  “Routine” is a key word here. I received an e-mail from a senior CMS staff member saying that “there is nothing in the regulation that specifies that claiming this exclusion precludes an EP from recording these vital signs on an occasional basis.” Therefore, the dilemma exists only for those physicians who routinely record one or two of the vital signs.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.