Archive for September, 2007

Medicine 2.0 Blog Carnival

September 17, 2007

Constructive Medicine has posted the blog carnival for this week. Cites this blog as well as some interesting postings on others. Next carnival will be by Clincial Cases and Images.

One note on the thinking about Medicine 2.0: “In next generation of medicine management, diagnosis and treatment of
diseases could be based on the spirit of collaboration and sharing of patient related knowledge.”

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New PHR – MyHealthArchive

September 16, 2007

This PHR is a product from PatientCentral Technologies, LLC, of Dallas. It is part of the PatientCentral Suite of products. They are described as: “First-order analysis of the database derives information about the movements of people and things. Second order analysis utilizes deduction, testing, modeling, and root cause analysis to yield insight about the clinical and business processes in play.”

The PHR tries to keep the process simple. There is a good explanation about why a PHR is important. They emphasize that theirs is NOT controlled by insurance companies, a telling statement in itself.

They state that one unique feature is “calendaring and preventive health functions” and promise security through a mechanism which is not detailed. Perhaps more detail on how they secure the data would encourage consumers to sign up.

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Health 2.0 in the Economist

September 15, 2007

Tipped off by a new comment, this article on Health 2.0 is one of the first in the public media to use the term. It discusses primarily patient-facing applications like discussion boards and quotes Gilles Frydman, the founder of the Association of Online Cancer Resources (ACOR), a group which has sponsored listservs for cancer survivors since the early days of the Internet.

It also quotes a study from a few years ago show in the inaccuracies on some patient discussion boards of 8% and the problem of anonymous postings.

While these problems remain, it is helpful to see more attention to Web 2.0 in health care, especially on the eve of the first Health 2.0 conference next Thursday in San Francisco. I will be one of 400 attendees. More on that later.

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Helpful Article on Choosing a PHR

September 14, 2007

In U.S. News and World Report, a brief article on selecting a PHR provides a good introduction to PHRs.

Examples are giving of desktop programs, internet-based and flash drives. Teathered PHRs which connnect to EMRs are also mentioned. The articles touts some benefits as well: “the payoff …is that patients become more knowledgeable about and more accountable for their health and their treatment.”

Missing in the article is information about security and long-term storage of records. But for this abbreviated view, the publication provides a good overview.

Also, I stumbled upon a new blog worthy of note: EHR PHR and Patient Portals by Electronic Health Record Consultants.

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Joint Commission Launches a Wiki

September 13, 2007

The quality monitoring Joint Commission has launched the WikiHealthCare – an initiative to “to foster collaboration among tens of thousands of health care professionals” on topics like patient safety and other health quality issues. This is a sea-change for the Joint Commission which traditionally acted as a regulatory agency to monitor hospital quality. Now it invites healthcare professionals to share best practices, define quality and patient safety through the interactive format of a Wiki. Initial topics include smoking cessation and the smoke-free hospital initiative. They have a helpful set of policies and guidelines to follow as well.

I can only congratulate their efforts and wait to see how these will take off.

When mainstream organizations in healthcare begin to adopt Web 2.0, then we know that Health 2.0 has arrived.

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Adam Bosworth Leaving Google?

September 12, 2007

According to Blogoscoped. No reason yet and how will this affect Google Health which he has led up to this point?

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Intelligent EHRs – What are they?

September 12, 2007

In an article on Government Health IT, the Intelligent EHR is discussed by a Mayo Clinic physician. Is is something more that an EHR with decision support tools? One quote says, “information becomes [directly] available and usable to a computer so one can repurpose that information for secondary uses such as quality monitoring and research and education.” The article also cites this as “minimally invasive informatics” which avoids disruptive changes in medical practice. But what does it really look like?

Is it simply decision support like alerts? This can result in alert fatigue. It may include quality monitoring, research, pay for performance, biosurveillance – all items which add value to the EMR. Yet there are “some barriers, particularly the increasingly complex ethical, political, technical and social issues surrounding secondary uses of personal information.”
Maybe the real future of an intelligent EHR with be something similar to the sematic web – intelligent agents bringing just the right amount of information to the point of care.

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Eye Movement and EHRs

September 11, 2007

In this report from the Boston Globe, titled “Eyes shift from patient to keyboard, the writers bring to light an important issue in implementation of an EMR – its affect on the physician-patient relationship. One study quoted in the articled noted that “about a quarter of patients felt as though computers reduced the amount of time their doctors spent talking with, looking at, and examining them. But just 8 percent felt that the computer actually interfered with the doctor-patient relationship.” On suggested approach is to “apologizing to her patients for turning away from them.” It also notes that using an EMR can add time to the visit. Part of this can be the tendency to review old notes (although one must wonder the amount of time it took to review paper records, especially for patients with chronic illnesses, or did the doctor just not bother because the information was too difficult to extract?). Is the trade-off here, less personal but perhaps safer medical care? Or at least better documented?

Related to this is a study reported in the Journal of the American Medical Informatics Association titled, “Electronic Health Records in Specialty Care: A Time-Motion Study”. This study of 15 physicians and 157 patients concluded that, “Following EHR implementation, the average adjusted total time spent per patient across all specialties increased slightly but not significantly.”

Both of these reports contribute to the ongoing attention needed to the social impacts of EMRs on provider-patient relationships.

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Revolution Health Lauches College Health website

September 10, 2007

Last week, Revolution Health launched a unique offering targeted to the college age demographic. The site includes information on mental health, STDs, birthcontrol, and healthy eating and sleeping. There is even a section for parents who may worry about their child’s health more than the student.

Special features seem to have an emphasis on mental health, such as, a mental health fair and crisis hotline. There is also an email newsletter on romance which appears to focus on young women and a safe drinking calculator.

The site covers the major concerns of college students.  In the past, most surveys showed an older demographic using health information websites. But Revolution Health, with its Web 2.0 interface, may successfully attract this hard to reach group.

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eHealth Initiative’s Fourth Annual Conference

September 10, 2007

This conference combines looking a current ehealth trends with a congressional panel. Some of the sessions include:

  • Aligning Financial and Other Incentives
  • Transforming Care Delivery
  • Improving Population Health
  • eHI’s Value and Sustainability Model for Health Information Exchange- Insights From America’s Most Advanced Stage Communities
  • Interoperability

and include speaker from the AARP to Microsoft.

Looks like a broad-ranging conference which would be well worth the time.

Hope to see some podcasts come out of the live sessions.

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