Archive for November, 2007

PHRs the Topic in HIMSS Digital Office

November 30, 2007

In the lastest issue of HIMSS Digital Office there are articles quoting two Cleveland CIO/CMIOs on PHRs. Dr. Harris of the Cleveland Clinic discussing the PHR/EHR integration as a culture change for his institution and states that “As more media, consumer, and provider attention is paid to the personal health record as both a concept and a tool, it is perhaps inevitable that PHR products of various quality and usefulness will arrive in the market place.”

Holly Miller, MD, MBA, the CMIO of University Hospitals of Cleveland and chair of the HIMSS PHR committee, discusses the push toward PHRs from Pay for Performance and about the future of PHRs, states, “a portable, interoperable PHR that is owned and controlled by the patient may provide healthcare consumers with necessary tools to better manage their health and wellness throughout their lives.”

There are also excellent articles on privacy and PHRs, and discussion of some products including Microsoft’s HealthVault which is not so much a PHR as a health information integrator.

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Cisco’s Telehealth Solution Promoted in the EU

November 28, 2007

In an article from E-Health Europe, a presentation from Cisco describes their strong commitment to eHealth. Specifically, they describe their decision to take leadership in “changing the way that people communicate to take control of their health.” One of the prototypes for this is HealthPresence technology which is being piloted in Scotland. It is a telemedicine solution which provides a unit which enables remote consultations. It includes a range of medical instruments and video-teleconferencing technology. This can have applications anywhere including for the rural U.S. where telemedicine solutions are now being incentivize by government programs.

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Web 2.0, 3.0 and beyond

November 23, 2007

From Minding the Planet, there is an unique graph of the historic and future progression from Web 1.0 to Web 4.0. It helps to categorize some of the current and yet to come trends in the field, such as Software as a service, semantic search and intelligent agents. While not trying to be comprehensive the diagram is missing Service Oriented Architecture. Perhaps Spivak will enhance the figure with time. But in its current state, it is still a useful tool for educating the IT masses about future trends.
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Patient as Googler

November 20, 2007

Matthew Holt points out an article from Time Magazine titled, “ When the Patient is a Googler.” The example given is of a woman who was doctor shopping and not getting the answers she wanted. “Susan had chosen me because she had researched my education, read a paper I had written, determined my university affiliation and knew where I lived.” And this physician thought she knew too much. Also, this physician prefers nurses and engineers as patients and begins to sound sexist in not wanting to deal with an emotional approach to illness. Although this patient certainly pushed the limits.

Many patients are “Googlers” and research their physicians more or less thoroughly. Researching important aspects of one’s own health care and knowing who your surgeon is certainly affects what your surgeon does. Is it overdone by some patients? Definitely. Does it empower others – most certainly.

Perhaps when we get to the semantic health care web, the results will be more even handed.

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Deborah Peel on Patient Privacy, Data Mining and HealthVault

November 20, 2007

Government Health IT has posted an interview with Deborah Peel of of Patient Privacy Rights (www.patientprivacyrights.org). She discusses the problems with data mining and how legal loophole allows it to continue. On the other hand, she states the Microsoft’s Health Vault has done it right in terms of protecting privacy including external auditors to protect the public. She also asks for protections from the current presidential candidates. Worth listening to and reading more on her organization’s website.

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Guide to Patients with Limited Literacy

November 15, 2007

Agency for Healthcare Research and Quality has published a guide on the Health IT needs for those with limited literacy. Reported by the American Academy of Family Physicians, this is a significant step in drawing attention to those who are beyond the digital divide in that they lack the language skills to interact with a computer. Some basic recommendations include: text should be written plainly in no higher than a 6th grade level, utilizing white space and short lines, appeal to ethnically diverse populations, and consider tools like kiosks. CHESS (Comprehensive Health Enhancement Support System) breast cancer module from the University of Wisconsin is given as a model, among others.

This report should be read by vendors, web developers, PHR creators and others who create patient facing IT systems.

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eHealthcare Leadership Awards

November 14, 2007

These awards were just announced. I had the privilege of assisting in the judging. The Cleveland Clinic made out well with a silver award for best health content, gold for best quality communication, platinum for center of excellence health content for the Heart and Vascular Institute and platinum for the best overall internet site all in the over 400 bed category. Revolution Health won several awards. Two pediatric hospitals won multiple awards: CHOP (Children’s Hospital of Philadelphia) and Akron Children’s Hospital.

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American Medical Informatics Association Meeting In Chicago

November 13, 2007

Only there in spirit, I found some interesting abstracts and hope to hear more about the presentations. One is a panel on “ Unintended Consequences of Health Informatics Innovations” which includes: PHRs place unrealistic expectations on patients, sharing of EHR information from different providers may threaten patient safety if the information conflicts, social networking may be “discouraging and increase self-medication”. and home monitoring may “may also change the home from a private to public space.”

Also, there is a section of the poster session devoted to Consumer Informatics and PHRs. And a late breaking session on Microsoft HealthVault.

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Consumer-Centric Health Care Congress

November 9, 2007

Video interviews are available from this congress being held in Washington, DC. One of the most interesting is Bridget Duffy, MD, who acknowledges the need to appeal to consumers who have the ability and initiative to shop for healthcare and how healthcare providers need to be transparent about outcomes.

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Web 2.0 for Doctors

November 9, 2007

In a story from the San Jose Business Journal, start ups for physician social networking are featured. The president of Sermo sees that the over 45 crowd of MDs are the “power users”. No time to meet in the doctor’s lounge, less time for social events but time online to be collegial  is what is suggested. Healthgrades and Medgadget are also mentioned. In trying to emphasize the need for health care to  become more consumer friendly, we  see this quote: “Fotsch of Medem predicts that as phone and video communication merge,

Web-based technology will gradually replace in-person office visits.” Now that may be out of context but there is potential for remote monitoring and exams which has already begun in rural areas. Maybe there is potential for the inner-city single mom as well who may need to take 3 buses with her baby to see a pediatrician.  Innovative models need to serve all.

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