Archive for 2006

Another Article on Patient Web Pages

October 2, 2006

This time from USA Today including citations of Carepages and others. “Mehring’s non-profit service is called
CaringBridge and is supported largely through donations, plus some hospital sponsors. The Langshurs’ for-profit service is called CarePages and has licensing agreements with about 500 health care facilities, including top-tier hospitals such as the Mayo Clinic and Cleveland Clinic. The participating hospitals add their logos to patients’ pages and get other benefits — including exposure to potential donors. Another service is theStatus.com.

“Though details differ, all the services allow anyone with computer access — in or outside a hospital — to quickly, at
no charge, set up a Web page to post updates and receive messages.

“One important feature: These highly personal sites aren’t detectable by search engines. Users can restrict who sees
them — or broadcast access information as widely as they like.”

Again, security and privacy in the context of social networking is key to the success and boarder adoption of these tools.

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Consumer-Directed Health Care Should Include Privacy

October 2, 2006

In a report on transparency on privacy issues by Jane Sarasohn-Kahn on iHealthbeat discusses the AMIA report on secondary use of health data, the author cites the constructive uses of such data for medical research. Educating consumers about this use is essential. “We cannot expect consumers to engage in the brave new world of consumer-driven health care without their expecting – and getting – privacy protections that stick.”  Tying consumer-driven healthcare and these secondary uses of data is important in empowering the consumer to take ownership of their data including allowing its use for research.

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Harris Interactive Report – Patients Communicating with Doctors Online

September 28, 2006

A 7 page summary of this report by Harris and the Wall Street Journal is now available in PDF format. Although “few patient user or have access to online services for communicating with their doctors, …most would like to.”

More conclusions: 68% think an EMR can reduce “redudant and unnecessary testing” but 62% think that EMRs make it more difficult to ensure privacy. 60% believe EMRs would reduce healthcare costs and 55% believe they would reduce medical errors.

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The End of Medicine – Book Review

September 27, 2006

Subtitled “How Silicon Valley (and naked mice) Will Reboot Your Doctor,” this book by Andy Kessler, a Wall Street analyst, takes the reader on a journey through medical technology conferences, genetic testing and cancer centers. His irreverent attitude spices up his quest to find how medicine can “scale” the way tech firms do in making cheaper, faster and growth-oriented technologies. Although he pans electronic medical records early in the book as not contributing in a significant way to the scaling of doctors, he continues his search down many dead ends showing how the current reimbursement incentives (especially DRGs) drive doctors toward specific, high reimbursement procedures and potentially stifle innovation. He spends several chapters looking at radiology innovations moving to 256 slices on CAT scans, only to find that technology may replace radiologist in finding tumors in mammograms. He looks at the concept of the gene chip, monoclonal antibodies and genetic tests. But when he comes across Don Lustwin who is funding detection and prevention research, such as, tumor markers, at the Hutch, he latches on where he believes the future is in healthcare.

The book is worth the read – it was a real contrast to Harvard Business books I have read, refreshingly so. If you can get past the attitude, enjoy the trip.

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New Bill to promote Personal Health Records

September 27, 2006

HealthcareIT News reports that Patrick Kennedy of Rhode Island is proposing a bill to create incentives for using PHRs. These payments would go to physicians for recruiting patients into a PHR. It would be a partnership of public and private funding encouraging contributions from third party payors and pharma. He expects interest by the private parties because of the potential for cost savings from activities like online prescription refills. Privacy and patient control standards would be set.

This is a great way to get some traction to PHRs which are of interest to consumers but where adoption lags.

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eCleveland Clinic Services include Sharing EMR with Referring Physicians

September 22, 2006

In the Cleveland Plain Dealer today, the DrConnect product is described as opening up the EMR to outside physicians. With the patient’s permission, a referring physician can view the record of that patient in a view only mode. This provides the potential for instant data exchange without the traditional methods of paper or fax. The article also explains the MyChart product from Epic Systems which allows to patient view into the EMR as well. The potential for improved continuity of care and reduction of errors is clearly evident as this kind of data exchange is expanded. The article did not emphasize strongly enough the security behind these ehealth products which is necessary to reassure the public.

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Healia Search Engine Launch

September 21, 2006

Healia, a health search engine reviewed in beta previously here, has launched. Still considered beta but improved, the tool is rich with features. I like the filters for gender, age cohorts and heritage which can also be hidden, the font size widget and search history. But one of the best features is the ability to go more general or more specific on each topic.There are also methods to incorporate the search into your site and an offer of business solutions.

The algorithms appear sound from a sampling of key health topics and the drug search has even more – a suggested result from sources like Medline, dosage, uses and side effects in tabs. The search results appear to be from trusted sources like WebMD, hospital websites, NOAH, government websites, Merck, etc. Attributes are assigned to each search result, such as, Advanced Reading, whether the site has a privacy policy, fast loading, and formatting for text browsers.

Can’t review a search engine without a comparison to Google and in this case, Google Co-op health. While Google is working on developing trusted sources through a subscription model and helping users narrow searches for some health categories, it does not provide the richness of a niche tool like Healia. Hospital websites should recommend tools like this which produce focused and reliable results.

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David Brailer’s Op-Ed in the New York Times

September 21, 2006

On September 19th, the NY Times published a piece by Dr. David Brailer on EMR and PHRs. In discussing current legislation on EMRs, he says, “These rules help doctors improve care, and at the same time push health information portability into the mainstream.” The difference in House and Senate bills are highlighted by a difference of opinion on portability: “Congress must confront as it tries to reconcile the competing versions of the bill: opposition to portable health information is, by definition, support for proprietary health information.” He cites the imporatance of portability as a do no harm issue – that is, that a vote against portability is harmful.

Couldn’t agree more with this and also his admission that getting there is costly and requires a significant commitment.

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American Health Information Community Consumer Empowerment Workgroup

September 18, 2006

This workgroup met in D.C. today and I was able to listen to some of the testimony and discussion online. The focus of the agenda was Personal Health Records. Particularly significant and referred to repeatedly was Paul Tang’s testimony based on Palo Alto Medical Foundation’s  PAMF Online (the powerpoint in PDF format available at the link above). He noted patient information needs including custom-tailored information and physician endorsement of health information. Regarding PHRs, he indicate that the consumer wants information related to visits, secure communication with their doctors, tools for managing chronic diseases but also had fears related to privacy and security especially that information is not shared with their employer.  Dr. Tang also detailed a sustaining value proposition including integrated delivery system, interoperable EHR/PHR, trust and physician adoption.

The session materials also include a Draft Visioning Matrix which is the next task of the Workgroup.

This Workgroup is worth keeping an eye on. You can sign up for email updates here.

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Demand for Online Health Services

September 12, 2006

According the the Wall Street Journal, a survey of consumers indicates that 64% want access to an electronic health
record; 74% want to communicate with their physician via e-mail; 77% want e-mail reminders when they should schedule a physician visit or some other type of medical care. And 54%  said an EHR would influence their choice between physicians. However, equal percentages do not have access to these services currently.

So the question is, how do we enable the general public who want these services to obtain them?  A few ways:  providers offer these services, more education of consumers of options to obtain these services through providers, payors or other online offerings.  With this kind of response, it appears that the concerns about security by consumers have lowered enough to encourage acceptance of these services.

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