World’s Best Healthcare?
August 14, 2007
In the Sunday NY Times, a major editorial on the current sorry state of healthcare in the US was sparked both by Sicko and by a report from the World Health Organization. It covers the usual complaints we have all heard before: insurance coverage, access, fairness, healthy lives, quality, life and death, patient satisfaction. Use of information technology is noted also as lagging other developed countries with lack of coordination of care.
In my mind this is as much an insurance issue as a technology issue – silos of information by for-profit insurance companies which will not be shared to coordinate care. Single payor makes sense but will be a tough sell without more lobbying reform as well.
I am glad that at least one editorial page is bringing this forward.
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Darwikinian evolution or folksonomic revolution?
August 14, 2007
I like how this article from The Medical Journal of Australia creates a dichotomy between two key Web 2.0 concepts – how wikis build knowledge from the survival of the fittest ideas to the folksonomy of simple tags replacing complex taxonomies. The authors, a medical librarian and two physicians, create a helpful overview of Web 2.0 in health care and discussion of some of the conflicts between Web 2.0 values and those of medicine. Specifically, they note: “The time between notification of an error and cleanup has recently been debated by health bloggers as a window of possible harm, and other problems of governance, liability and accuracy have been raised in rapid responses to Dean Guistini’s recent BMJ article on Web 2.0.”
Regarding social networking, “students of all ages learn best when immersed within a culturally and socially rich environment in which learners and peers are committed to achieving the same goals and can regulate each others’ performance.” A real plus for medical and allied health education.
Share this:PHR Fragmentation
August 10, 2007
On Digital Healthcare and Productivity, David Lansky, senior director at the Markle Foundation , was interviewed on the current state of PHRs. He notes the variety of sponsors for PHRs as leading to “digital silos”. On patient empowerment, “it doesn’t add up to an empowered consumer until the network environment permits information to flow into a tool that the consumer controls and manages.” On privacy and security: “patients need to know there is an audit trail.” On data accuracy in PHRs: “The issue will be less the authoritativeness of the raw data than the ability to translate it into something useful in terms of a clinical decision-making encounter.”
The solution is “It’s really about the way we deliver healthcare and access information.” not necessarily about the technology or payment reform.
Share this:Online Support Groups
August 9, 2007
I recently heard about MD Junction, another online support community with very specific groups including fibromyalgia, ADHD and pulmonary hypertension. There is also a longer list of health forums and find a doctor tools with patient reviews. The site puts some emphasis on identifying diseases by ribbons which some patients and families find particularly helpful.
Does it have advantages over longer standing online groups such as MedHelp or more well funded ventures such as Revolution Health? Time will tell as the Health 2.0 market settles out in the near future.
Hype Cycle of tagging
August 8, 2007
In the grand Gartner tradition, Philipp Keller has developed a lifecycle of tagging. Interesting history of this trend but I am surprised it took a dip in early 2007 considering the ongoing trend for new tagging sites and the sheer growth of Digg, Flickr and others.
Worth the read.
Share this:SOA in Healthcare
August 7, 2007
IBM and the University of Florida are teaming up to create a wireless Service Oriented Architecture (SOA) to enable mobile devices to deliver health data. “This technology will enable automatically recognized devices to send the information they register to authorized third parties, such as specialized healthcare providers.”
The more detailed article in PC World states “It will be up to device manufacturers to ensure that their products
are tamper-proof to avoid the possibility of false readings.” Certainly some strong service level agreements needed here.
“As a way to start building momentum behind the technology, IBM has contributed components of the project to the Open Health care Framework of the open-source development tools Eclipse Foundation community.”
Share this:A Business Model for Telehealth?
August 3, 2007
In iHealthbeat, a feature on the Idaho telehealth program explores the issue of creating sustainable models for telehealth. They wisely point out that even academic programs like this one with a broad network of connectivity throughout the state can be in trouble we grant funding runs out. What better place to experiment that a rural state like Idaho. But where is the business model. Will Medicare provide the ongoing reimbursement? What about major insurors within the state? Business partnerships?
Sustainable business models are sorely needed now that the technology is readily available. But as in other studies, the cost of home monitoring and telemedicine needs to come down. Here is a chicken and egg dilemma – should the price come down to sustain the business or will more business drive down the cost?
Share this:Healthcare 100
August 2, 2007
Made in into the top 200 blogs on this list. 184 – in the honorable mention category. A growing list of blogs.
Share this:Benefits of Patient-Provider email
August 2, 2007
On Healthline TechMedicine, Joshua Schwimmer creates a helpful list of the benefits of email exchanges between physicians and patients. These include:
- Asking about lab results
- Reporting potential side effects of medications
- Clarifying whether it’s safe to take a certain medication
- Reporting home blood pressure readings
- Asking for prescription renewals
- Reporting new minor (but important) symptoms
- Communication new medical issues when out of the country
Now of course a structured application which enables this communication may be preferred to a open, unsecured email. Well designed PHRs include functions to request script refills, see lab results, and record home self-monitoring (although fewer PHRs have this feature). Another argument for tethered PHRs with an interface into an EMR?
Share this:KP Online offers more features
July 31, 2007
Kaiser Permanente Health Connect launched in 2005 for Northern California. It has the standard features for a teathered PHR – appointments, test results, and now includes secure email with providers. Some procedures are described step-by-step as an example of its integration with health information. Adoption has been steadily increasing, now up to 42,000. In this same article in scabee.com (Sacramento Bee newspaper), UC Davis’ MD Online boasts 25,000 patients online, although it does not mention if they are using a specific PHR product.
Maybe the tipping point for PHRs is those which are teathered to an EMR because basic services are offered up front despite the lack of ability to add one’s own content. There is also the advantage of a trusted source owning the PHR, the hospital or provider group.
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