Predicting Health IT Five Years Out
August 30, 2010
In an article in xConomy Seattle, there is a report from a meeting of the Washington Biotechnology and Biomedical Association, reporting on the future of Health IT. Some key predictions:
- “As we near 2015, many in the industry predict healthcare will see an integration of social media, cloud computing, and collaborative commons—creating resources that allow consumers to more actively engage with their health through information technology.”
- “primary care facilities and hospitals are not capitalizing on the existence of electronic resources to provide better care for patients and improve efficiency for healthcare providers”
- “Healthcare is the last bastion of mom and pop stores,” ?The first step in healthcare is to make everything digital,” “The next step is to takes what’s digital, and make sense of it—to make some intelligence out of the information you already have.”
- “Arguably healthcare is a data problem, and we’re trying “Scientists are not thinking of their data as an ingredient to the solution. They’re thinking of it as an ingredient to their next paper,”
- “researchers will have to amend not only what they do, but how they go about doing it—the emphasis will become less about research and clinical data, and more about how that data is stored, accessed, and used”
- “models could also use the power of social networks to give patients access to information and resources provided by other patients with similar conditionals—data that could help patients research and decide on a treatment plan, as well as help physicians make recommendations.”
- “One example would be using personalized data from electronic medical records, combined with data from available studies, to create individualized predictive care models.”
All great ideas held back by cottage industry attitudes and slow adoption of EHRs and PHRs. My only question is, why can’t we have this sooner than 5 years?
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Open Notes Project – Right Thing or Wrong Question
August 18, 2010
The discussion of having doctors notes on one’s care readily available electronically was stimulated by a recent New York Times article titled, Should Patients Read the Doctor’s Notes? Roni Zeiger of Google Health challenges whether this is the right question. For e-Patients, it is both the wrong question or obviously the right thing to do. Transparency of medical records, now written into health care reform, is the obvious right thing to do but will take time for physicians to catch up to the idea. Granted that few patients even have access to a PHR tethered to and EMR, but at least those that do should have access to notes in the long run. If patients are to be full participants in their health care and treatment, they should know their doctors observations and treatment plans. As Roni Zeiger says this is one of “the best ways for the patient to understand and remember the doctor’s guidance.”
Share this:IBM Initiative to Improve Healthcare Quality and Costs
August 6, 2010
Recently IBM announced a major initiative to address significant data problems in healthcare. Acknowledging the fact that data is in structured and unstructured format and from various sources, the task of integrating these data points into a individual dashboard format can enable better medical decision making. One tool to enable this kind of data integration is their text analytics tools LanguageWare™ (LW) and Cognos Content Analyzer (CCA). Both of these were acquisitions by IBM in the past few years and it appears that they are now integrated enough to be used with large data sets in health care. Analyzing unstructured information can benefit insurance companies as well. The tool looks like it combines natural language search and semantic technologies. The video illustrations the typical international approach of Big Blue.
Share this:American Association of Medical Colleges – Group on Information Resources
July 22, 2010
Next week I am attending a leadership institute of the AAMC in La Jolla, California. This week-long institute is by nomination – a group of 33 of us will attend, many CIOs and other leaders in healthcare IT and library science at academic medical centers. The program is very participatory with small groups making up much of the time as well as some lectures from a diverse faculty. Doing preparation for the institute has provoked thinking about leadership concepts and how to influence change in academic organizations. Although the term innovation is not explicit in the program, it certainly is on my mind as I prepare. One of the readings in preparation is from the book, Medicine and Business: Bridging the Gap by Sheldon Rovin, particularly chapter 3 on Leading Change. Also recommended to me are:
- Managing Change from JAMIA
- Developing Physician-Leaders
I have to give credit to all those supporting my attendance and interested in the outcome. There is the potential for a major impact on my career and outlook. Looking beyond managing programmers and supporting research projects, there are opportunities to influence the future of medicine. I want to be a part of that.
Share this:What’s New with PHRs – evidence and interoperability
July 16, 2010
A new study from Kaiser documents some clear clinical benefits for the use of PHRs. The study, which was published in the July issue of Health Affairs, observed 35,423 patients with diabetes, hypertension, or both. Researchers found that the use of secure patient-physician messaging in any two-month period was associated with statistically significant improvements in HEDIS (Healthcare Effectiveness Data and Information Set) care measurements. Results included 2 to 6.5 percentage point improvements in glycemic, cholesterol and blood pressure screening and control.
Also, there is a good video on PHR/eHealth application interoperability which also promotes the Health 2.0 Accelerator. The future of patient centric care must be interoperable. Watch the video.
Part of the video is a demo of SurveyorHealth for managing medications which includes an interesting tool Simulate Alternatives. Check out one of the demo patients.
Share this:Health 2.0 – a Double Dutch Treat
June 30, 2010
Lucien Engelen of Radboud University, Nijmegen, NL, and his team (Tom Van De Belt is the first author) have struck two goals in the world cup of Health 2.0. In the Journal of Medical Internet Research, they have published “Definition of Health 2.0 and Medicine 2.0: A Systematic Review.” This broad review of published literature and blogs included a post by me and many others. They note no consensus on these definitions but some recurring themes:
- Web 2.0/technology
- patients
- professionals
- social networking
- health information/content
- collaboration
- health care change.
The second publication is “A Little Booklet About Health 2.0“, originally available in Dutch, now in English for the Kindle, soon to have an English paper edition. This modest title provides a good introduction to Health 2.0 for beginners and those who may have concerns about venturing into this growing field. It is a quick read and dives right into the key topics, using the example of MyCareNet, an innovative interactive platform for IVF patients and providers and leads us to the concept of participatory healthcare and bringing in the patient’s perspective on service design.
These two publications demonstrate some of the growing Dutch leadership in Health 2.0 which will culminate in the Medicine 2.0 conference in Maastricht this November and the TEDxMaastricht program.
Share this:Declining Marginal Returns of Complexity
June 21, 2010
Just completed the book The Collapse of Complex Societies by Joseph Tainter, an archeologist. The focus of the book is on civilizations like the Roman Empire and the Mayas but it made me wonder about the complexity of health care and whether we are at the point of declining marginal returns. It is apparent from the health care reform experience that competing stakeholders make any attempt at reform a complex and nearly impossible process. Clay Shirky wrote a blog post in April on The Collapse of Complex Business Models. Just like societies which become too complex to respond to major stressors. While I am not predicting the collapse of health care in the US but one must wonder whether some of the complexity could be simplified by the experience of other countries, such as, single payer systems and an emphasis on primary care (medical home). Would be interested in other opinions, especially from those who have read the book.
Share this:Curing Cancer Clinical Trials
June 17, 2010
The Institute of Medicine has issued another groundbreaking report, this time on cancer clinical trials. An editorial about the report in the New England Journal of Medicine titled, Cancer Clinical Trials — A Chronic but Curable Crisis, makes some bold statements, such as, “the program is bloated, cumbersome, inefficient.” Slow approval processes with multiple layers and poor recruitment levels are symptomatic.
Recommended changes include improving:
- the speed and efficiency of the design,
- launch, and conduct of trials;
- innovation in science and trial design;
- trial prioritization,selection, support, and completion; and
- incentives for patient and physician participation
The full IOM report lays out participation of key stakeholders, particularly patients and physicians. The emphasis on patient participation is strong and reminiscent of the e-Patient White Paper. While the concept of the Lethal Lag Time is not directly mentioned, the overtones can be heard. I recommend this report as key to the future of the conduct of clinical trials including innovative approaches.
Share this:Partnerships with Online Communities – The Long Tail
June 4, 2010
Chris Anderson in writing Long Tail: Why the Future of Business Is Selling Less of More, popularized this concept particularly in viewing markets in the wired world. How does it apply to health care? Probably in many ways. But specifically it came to mind in thinking about the relationship of provider organizations like hospitals and online communities. While many online communities may attract large numbers, for instance, in diabetes and breast cancer, many more condition specific communities are relatively small even though they may have a national or international scope. Gilles Frydman of ACOR recognized this early by encouraging the proliferation of online communities through his listserv.
Provider organizations are moving into social media but struggling to identify meaningful ways to connect with their patients through Facebook and Twitter. Perhaps the struggle has to do with a broad stroke strategy of trying to appeal to all comers. The real opportunity is in the Long Tail of small online communities who know the best hospitals, information sources, physicians for their disease or condition and talk to each other about it all the time. Certainly PatientsLikeMe.com has found this in the specialize community of ALS and others like it have found the value in the long tail. What about groups like Marfan Syndrome or others that fall under the umbrella of the National Organization of Rare Diseases (NORD). Specialist who treat these diseases in the long tail of healthcare have a unique opportunity to become online partners potentially contributing to blogs, social networks or listservs and inviting patients to post blogs about their experiences on the hospital’s blog or Facebook page. There are many possibilities to explore – meetups, suggestions for improving care – hope to see some take up this challenge.
Share this:Technology and the Future of Chronic Care
May 24, 2010
Accenture has published a report on “Connected How Technology Will Transform the Future of Chronic Care.” From the Accenture Innovation Center for Health, a good source for research white papers. The paper reports that “a broad range of consumer health electronics at home, a two-way, direct-to-consumer infrastructure” and smart devices which set the stage for health care connectivity. Analytics and predictive modeling provide a second layer and visualization, decision support and collaboration provide the third. Connect health examples include the HealthVault and Cleveland Clinic home monitoring pilot and a remote monitoring trial by the VA system.
There is no doubt that the convergence of technologies have the potential for revolutionizing chronic care, however, we must go past the pilot stage and initial startups to broader change. Partnerships between consumer electronics, startups, providers and insurers need to come together with government support. Perhaps after the first wave of meaningful use EHRs, this new level of innovation can flourish.
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