Project Health Design Grants Announced
December 8, 2006
Project HealthDesign of the Robert Wood Johnson Foundation, has announces its grants related to innovation in personal health records. The grantees are:
- University of Rochester, Personal Health Management Assistant
- Joslin Diabetes Center, Inc, Personal Health Application for Diabetes Self-Management
- University of Washington, Chronic Disease Medication Management Between Office Visits
- Vanderbilt University Medical Center, My-Medi-Health: A Vision for a Child-focused Personal Medication Management System
- University of Massachusetts Medical School, Supporting Patient and Provider Management of Chronic Pain with PDA Applications Linked to Personal Health Records
- Research Triangle Institute, ActivHealth: A PHR System for At-Risk Sedentary Adults
- Art Center College of Design, Living Profiles: Transmedia Personal Health Record Systems for Young Adults
- University of Colorado at Denver and Health Sciences Center, Assisting Older Adults with Transitions of Care
All sound interesting and great contributions to the relatively new and growing PHR field. I look forward to the results of these efforts.
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Americans Positive about EHRs/PHRs – Markle Survey
December 7, 2006
In a new survey released today by the Markle Foundation, reports that the “Survey shows that consumers view personal health records as an important element in reducing medical errors and increasing quality of care.” Yet 80% were concerned about privacy and the possible use of information by marketers. 75% see a role for government in protecting their privacy. The report on the survey will be presented at the Connecting Americans to Their Health Care conference in Washington, D.C. The conference includes a keynote address by Adam Bosworth of Google.
Share this:The Dossia Initiative in PHRs
December 6, 2006
Announced today was as employer coalition to enable personal health records to be aggregated from different sources. This initiative managed by a non-profit called Omnimedix has an invitation to join on the Dossia website. The reports indicate a full release in mid-2007. Other companies are working on similar initiatives.
Will this be a first to market win or more dependent on major partnerships and ease of use? Wait and see.
Share this:Consumer attitudes toward PHR, EHR
December 6, 2006
In a new study release by Price, Waterhouse, Coopers, Top Seven Health Care Trends in ’07, there an indication of low confidence that EHRs will improve care (34% yes) but a larger group who are undecided or need more information (42%). I don’t agree with the report title in Healthcare IT News which says, “Consumers don’t believe EHRs will improve care, report says”. I think the lesson from the report is the need more information. The failure here is not communicating the importance of EHRs and PHRs and the value they provide to the consumer.
Also in the report is the trends toward “Consumers taking the wheel” (consumer driven health plans success will depend on word of mouth reports) and “Private equity investors will fund the next generation of innovation in services and treatments, challenging larger competitors that lack market agility.” This will be true not only in minute clinics but other new practice venues.
New York Times on Privacy and EHRs
December 4, 2006
In the December 3rd edition of the New York Times, a story titled “Health Hazard: Computers Spilling Your History” examines privacy of electronic medical records. In addition to finding how hospitals can successfully defeat attempts of employees to sneak a peak at medical records of the rich and famous (including President Clinton), the author cites concerns in Congress, e.g., “But the toughest challenge may be a human one: acute public concern about security breaches and identity theft.” This is cited as the major barrier to adoption of EMRs by physicians in the U.S. while other western countries have up to 89% use. One observation of a policy analyst: “If you don’t have the trust of patients, they will withhold information and won’t take advantage of the new system.”
Well said, but much of the task of protecting privacy is proper planning and implementation of systems. One of the biggest threats appears to be health care workers who store patient data on laptops. With all the methods of securing laptops or better yet, accessing centralized systems through secure channels, why should this continue to be a risk.
One note on PHRs: “EVEN without new federal laws to guide them, some companies have begun
to encourage their employees to embrace electronic medical records. At Pitney Bowes, employees are paid a bonus if they store a copy of their personal health records on WebMD.com, the medical Web site.” An encouraging sign and a new way to use incentives.
Diagnosis Google Style
November 27, 2006
Lots of buzz on the British Medical Journal article on Googling for a diagnosis–use of Google as a diagnostic aid: internet based study. The study showed “Google searches revealed the correct diagnosis in 15 (58%).
The comments on the BMJ website related to this article are equally interesting: “Pubmedding is better than googling” and Google Medicine – proceed with caution and this quote: “Google’s accuracy of 58%, reported by Tang and Ng, is less than that achieved by older generation rules based Diagnosis Decision Support System [3] and will not engender widespread adoption.” In fact, would you be confident of this kind of percentage.
Perhaps a more realistic test would be to give two physican panels test cases and two different tools sets – a decision support tool like Micromedix and the other just Google and see how accurate they become.
At any rate, the article provokes more discussion and research.
Share this:Trivergence
November 25, 2006
On Future HIT, I found a post about trivegence. Trivergence is a new concept defined by Accenture as the meeting of devices, controls and data. They argue that because architecture now supports multiple devices, that the integration of controls and data into devices now enables unique opportunities. While convergence refers to “the unification of voice, data and video on the network level”, “Trivergence is an architecture that brings a new organization to devices, networks and controls. The conceptual breakthrough is that if a device is on the network, its controls can be located somewhere other than on the device itself. As a result, devices that used to be stand-alone entities are now cogs within a much larger system—a system that enables new user experiences through the interaction of its components.”
What about trivergence in healthcare? Certainly as more devices in clinical settings become connected to networks, the implications can be huge. Perhaps the greatest implications will be in telemedicine.
Share this:Health Care 2.0 – Home Monitoring
October 13, 2006
CNN reports on Wednesday how home monitoring can significantly impact medical costs. The give examples of home dialysis and Health Buddy and note in the latter that adult children can use it to monitor their elderly parents. Health 3.0 as the next generation include genetic testing services, retail therapy/clinics, second opinion for medical bills and more entrepreneurs like Steve Case and his Revolution Health.
While the mimicking of Web 2.0 can get old, certainly home treatment and monitoring and new health delivery models are becoming more prevalent. However, it is hard to predict the adoption rate of these new services – much will depend on reimbursement/business models and the consumer’s trust in these delivery systems.
Share this:Assessing the impact of eHealth – a European Perspective
October 13, 2006
In an article on the eHealth News blog, the authors cite a report called eHealth Impact, which showed significant return on investment for eHealth projects. The authors interpret this with some caution, however. “During the research, the team discovered that ineffective eHealth services are often caused by poor service implementation. They
therefore analysed the ten evaluated sites to identify lessons to be learned for successful implementation of effective eHealth solutions.” The eHealth Impact project ” focused on the three stages in the lifecycle of eHealth investments – planning and development, implementation, and routine operation. The project team developed a set of tools to collect relevant information on each stage.” They note that it is difficult to create a standardized way of studying economic impact when the eHealth projects are so diverse. A big factor is stakeholders: “The more stakeholders and the earlier they are brought in, the greater the chances of success.”
Share this:eVisits to Be Covered by Some Insurors
October 9, 2006
An article from Minneapolis indicates that two insurance companies in Minnesota are planning to cover evisits. This means a $35 fee for each email to a patient. The article notes that physicians have been slow to adopt (in some cases complete avoid) email as a form of communication with patients due to lack of reimbursement. The Minnesota experience shows a slow rate of adopting (100 patients in 5 months for HealthPartners) which is similar to the gradual adoption rates of personal health records. Patients who are early adopters or those with chronic illness and significant travel time may be the initial users in this technology especially in areas where internet usage and higher bandwidth is still growing. But many parents and family caregivers are using the internet at home and work and will begin to adopt this if they get a timely response from the physician.
The article did not discuss secure email or how users may feel about privacy.
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