eHealth Progress
October 6, 2006
In an editorial by Henry Potts of London, he raises the question, “Is E-health Progressing Faster Than E-health Researchers?” Some of the quotable answer includes: “Traditional healthcare, given its safety critical context, utilises an evidence base and a process of risk management that generally involves some sort of governance. These are conflicting trends: the great value of the Internet is how easy it is to make material available, but the strictures of safety and proof of efficacy run counter to that. How do we garner the benefits of the Internet – the democratization of production and distribution that has produced so much content – while maintaining safe and good practice?”
And in an acknowledgment to social networking, “Beyond healthcare, there are many more innovations that draw on user-generated content and the Internet’s democratization of production and distribution. The “killer application” in e-health will perhaps be something that can marry the democratized nature of MySpace or Wikipedia with the safety critical nature of healthcare.”
These conflicting values of control and freedom are particularly acute in web-based consumer directed healthcare. Web 2.0 values need a way to take root within healthcare.
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Are Physicians Ready for Patients With Internet-Based Health Information?
October 3, 2006
This article appearing in the Journal of Medical Internet Research by a Canadian group of authors is a study looking at how physicians deal with a common phenomenon of the Internet Age: patients bringing Internet health information to their appointments.Themes include: “(1) perceived reactions of patients, (2) physician burden, and (3) physician interpretation and contextualization of information.” Generally, physicians found this information problematic and enough of it misinformation that it could cause distress and confusion.
Four conclusions:
- physician awareness leading to acceptance of this information in the exam room as the norm
- physician training in redirecting patients to recommended web resources
- rewarding the time-pressed physician for competence in information technology (incentives)
- patient education on how to search for information and the appropriate use of that information within patient-physician communication.
The need for strategies to address this challenge in physician-patient communication is essential. Prescribing health information is one tested approach. By physician approaches need testing as well.
Share this: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.
Share this: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.
Share this: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.
Share this: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.
Share this: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.
Share this: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.
Share this: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.
Share this: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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