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How Health Care Organizations Can Get More Out of Big Health Data

How Health Care Organizations Can Get More Out of Big Health Data | Audiology | Scoop.it
Use big data wisely by automating tasks, personalizing treatment and improving communication between physicians and patients.

In our information-infused age, health care organizations can use big data to improve quality of care and outcomes for patients, especially those with chronic conditions. Equally important, they can harness the power of big data to prevent diseases and improve wellness initiatives.

Growing use of electronic health records plays a big role in building up health care data sets. As of last year, nearly six in 10 hospitals had adopted at least a basic EHR system, according to the Office of the National Coordinator for Health Information Technology, and 93 percent had a certified EHR system in place. The National Ambulatory Medical Care Survey also showed that in 2013, close to 80 percent of office-based physicians used some type of EHR system. These systems play host to structured and unstructured data — including a mountain of physician notes — for millions of patients across the country, all of it ripe for use in analytics to help improve and personalize treatments as well as in predictive modeling to better understand where risks lie.

Doing the Right Thing

A recent conversation I had with Blackford Middleton, M.D., chief informatics officer at Vanderbilt University Medical Center, made it plain that leading-edge institutions want to build clinical decision support systems that exploit big data — an organization's high-volume, high-variety, high-velocity information assets. The goal, as the good doctor put it: "to ensure the right things happen for the right patient at the right time."

Vanderbilt University Medical Center is taking on some big data–infused efforts to improve the quality of care it renders under the new value-based health care services model. At the same time, it wants to use big data to reduce unnecessary services.

"We don't need to do thousands of hospital and ambulatory care tests that don't impact care outcomes. Do more of the right ones and fewer of the wrong ones and you will lower costs and increase the value of care provided," Middleton says. Those same results can be achieved when health care systems analyze big data to help a patient avoid a single emergency clinical visit, for example, or an inappropriate medication that has adverse effects.

A big part of getting to this end, though, is moving to a continuous care model that extends the doctor-patient connection beyond scheduled visits. Good continuous care is dependent on more regular infusions of patient data than the updates generated during visits — it requires engaging the patient to be a more active participant in his or her own health care.

It also means investing in communications and other technologies so patients can respond more easily to between-appointment recommendations such as changes in treatment plans. And, it requires coming up with solutions to ensure that the data obtained can be put to use effectively. Such extensions of the connection between the health care team and the patient should translate into successful outcomes and mitigate excessive care costs.

The Road to Better Health Care

Here are five ways your health care organization can work with patients, and with their data, to build a better care model:

Make the patient a responsible member of the health care team. In some respects, it's easier than ever to do so, given the range of smartphone apps, fitness wristbands, smart watches and other tools to record exercise, food intake, weight and blood pressure and transmit it to health care providers. Maybe, suggests Middleton, health care providers should take a closer look at ways to use these tools to make such data contributions into a gamelike experience "to maximize the health care productivity function for each patient."

For example, perhaps patients with high blood pressure conditions can accumulate points for every reading they transmit, and once they reach a certain number, exchange them for a coupon for a healthy smoothie at their next doctor visit. Understanding how various measures consistently trend over time, after all, can be important for doctors treating patients with chronic conditions such as diabetes, hypertension, obesity and even depression.

Think ahead to a holistic approach to data acquisition and analysis. In addition to driving a continuous care model with the help of patients' self-reported information on structured data points, other data — perhaps in unstructured format — can be included in the patient-care analytics mix. As Middleton points out, social, cultural and environmental factors play a big part in people's health and can provide important context for health care management. Commentary on social networks, employee wellness program information and community health statistics — all are venues that might provide useful data related to these parts of patients' lives.

As Middleton says, "There are a lot of issues to be wrestled with," such as getting patients to authorize access by providers to their private information. "But, I think it will come. I think patients will be willing to trade off what's viewed as privacy against what they may view as bringing convenience or value to them."

There is an opportunity, as well, to combine a better clinical understanding of patients with an already robust financial understanding of those same individuals, based on the data stored within health care organizations' administrative systems. Incorporating patient receivables data into health care analytics processes, for example, can help a health care system to understand if it has been successful at effectively engaging patients in their own health care.

Remove the noise. While there is value to be gained from adopting electronic medical records, health care organizations also find that the current generation often floods them with too much undifferentiated information. It's a work in progress for many hospitals to synthesize and distill from that flood the essential signals that pertain to the care of a particular condition for a particular patient. And, as data come in from more sources, perhaps in different formats, the synthesis and distilling challenges are poised to grow.

Vanderbilt is taking steps to meet aspects of the challenge of highlighting important EHR data with projects like Pharmacogenomic Resource for Enhanced Decisions in Care and Treatment, or PREDICT. PREDICT works so that automatic point-of-care decision support is launched when a certain drug is prescribed for individuals whose EHR data indicate that they are at risk for variant genotypes. "Personalization becomes very real," Middleton says.

Let the data inform task automation. As more information becomes part of the health care equation, health care professionals can spend more time doing what they love: engaging in the hands-on care part of the equation while letting data analytics drive task completion.

For example, it is possible to have data from EHRs, sensors and wearable medical devices feed into the health care provider's patient engagement system and trigger just-in-time patient engagement communications specific to that individual. That way, a health care worker doesn't have to, for example, manually monitor incoming data to direct a response to a spike in a patient's glucose levels. Rather, business rules can be created to assess the level of urgency and take the appropriate next step, such as scheduling a screening appointment if the rise in glucose levels was minimal.

Better facilitate feedback from providers to patients.Health care communications infrastructures have unfortunately lagged behind those found in many other sectors. The ability to acquire and analyze more data to drive best-evidence and best-experience recommendations in a continuous care model can't be underestimated.

But the promise of technologies such as wearable devices and EHRs is negated if providers can't deliver their findings — or any information, advice or encouragement — to patients using the communications pathways a patient prefers, whether that's via Web portals or personalized, automated emails, voice mails or text messages. According to the TeleVox Healthy World Research Initiative, for example, close to 50 percent of patients prefer email for communications about patient care between visits, followed by text messaging at 31 percent.

Sadly, when patients disengage, health care organizations risk recurrence of events that might otherwise have been avoided. Says Middleton, "Patients' preferences and utilities impact to a great degree how we see them engage in care or pursue healthy outcomes and behavior."

We know there will be obstacles to overcome in adopting new ways of working with patients and data to turn the vision of continuous care into a reality. But we also know that we can't fail — not if we are to create a more healthful populace without further driving up health care costs.
 
Scott Zimmerman is a published authority on using technology to engage and activate patients. He is the president of TeleVox Software and spearheads TeleVox's Healthy World initiative, which uses ethnographic research to uncover, understand and interpret patient and provider points of view.


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24 Outstanding Statistics on How Social Media has Impacted Health Care

24 Outstanding Statistics on How Social Media has Impacted Health Care | Audiology | Scoop.it
Communication has been disrupted through social media but how has the health care industry faired? Dive into an analysis of 24 statistics on the subject.

Via Dean Berg
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JAMA Viewpoint Calls for Revising Physician Social Media Guidance - iHealthBeat

JAMA Viewpoint Calls for Revising Physician Social Media Guidance - iHealthBeat | Audiology | Scoop.it
In a Journal of the American Medical Association viewpoint, three ethics and psychiatry experts from Johns Hopkins University argue that industry guidelines on physicians' use of social media should focus on what is appropriate for a physician to...

Via Richard Meyer, Marie Ennis-O'Connor, Dean Berg
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Hearing Review - NIDCD Researchers Discover Two-Step Mechanism of Inner Ear Tip Link Regrowth that Could Save Hearing

Hearing Review - NIDCD Researchers Discover Two-Step Mechanism of Inner Ear Tip Link Regrowth that Could Save Hearing | Audiology | Scoop.it
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Interaural Differences of Distortion Product Otoacoustic Emission Amplitudes in Patients with Unilateral Tinnitus

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Hearing Review - For Whom the Decibel Tolls: The dBA vs dB SPL War - January 2013 Hearing Review

Hearing Review - For Whom the Decibel Tolls: The dBA vs dB SPL War - January 2013 Hearing Review | Audiology | Scoop.it
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Early Intervention in Localized Wegener's Granulomatosis With Sensorineural Hearing Loss Preserves Hearing -- Sriskandarajah et al. 21 (2): 121 -- American Journal of Audiology

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Superior Semicircular Canal Dehiscence in Patients with Spontaneous Cerebrospinal Fluid Otorrhea

Objective To determine the prevalence of superior semicircular canal dehiscence (SCD) in patients with spontaneous cerebrospinal fluid (CSF) otorrhea.


Study Design Case series with chart review.


Setting Tertiary care referral center.


Subjects and Methods Patients included have undergone a middle fossa craniotomy for repair of spontaneous CSF otorrhea between January 2007 and December 2011. The main outcome measure is the presence or absence of SCD observed during spontaneous CSF leak repair. Computed tomography (CT) imaging was also reviewed to determine the diagnostic accuracy of this modality

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Ida Institute's Newest Tool Strengthens Clinical Supervision on ADVANCE for Hearing Practice Management

Ida Institute's Newest Tool Strengthens Clinical Supervision on ADVANCE for Hearing Practice Management | Audiology | Scoop.it


In the transition from classroom to clinic, audiology students depend upon experienced clinicians to help them implement academic skills in interactions with patients in real-world clinical settings. The Clinical Supervisor Kit, Ida Institute's newest tool, supports clinicians in this critical training role, offering a comprehensive background on patient-centered care and practical strategies for effectively mentoring students in clinical training situations

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Effects of Bandwidth, Compression Speed, and Gain at High Frequencies on Preferences for Amplified Music

This article reviews a series of studies on the factors influencing sound quality preferences, mostly for jazz and classical music stimuli. The data were obtained using ratings of individual stimuli or using the method of paired comparisons. For normal-hearing participants, the highest ratings of sound quality were obtained when the reproduction bandwidth was wide (55 to 16000 Hz) and ripples in the frequency response were small (less than ± 5 dB). For hearing-impaired participants listening via a simulated five-channel compression hearing aid with gains set using the CAM2 fitting method, preferences for upper cutoff frequency varied across participants: Some preferred a 7.5- or 10-kHz upper cutoff frequency over a 5-kHz cutoff frequency, and some showed the opposite preference. Preferences for a higher upper cutoff frequency were associated with a shallow high-frequency slope of the audiogram. A subsequent study comparing the CAM2 and NAL-NL2 fitting methods, with gains slightly reduced for participants who were not experienced hearing aid users, showed a consistent preference for CAM2. Since the two methods differ mainly in the gain applied for frequencies above 4 kHz (CAM2 recommending higher gain than NAL-NL2), these results suggest that extending the upper cutoff frequency is beneficial. A system for reducing “overshoot” effects produced by compression gave small but significant benefits for sound quality of a percussion instrument (xylophone). For a high-input level (80 dB SPL), slow compression was preferred over fast compression.

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Ear diseases and other risk factors for hearing impairment among adults: An epidemiological study, International Journal of Audiology, Informa Healthcare

Ear diseases and other risk factors for hearing impairment among adults: An epidemiological study, International Journal of Audiology, Informa Healthcare | Audiology | Scoop.it

Objective: To investigate the prevalence of ear diseases, other otological risk factors potentially affecting hearing, and noise exposure among adults. Furthermore, subject-related factors possibly associated with hearing impairment (HI), i.e. handedness, eye color, and susceptibility to sunburn, were studied. Design: A cross-sectional, unscreened, population-based, epidemiological study among adults. Study sample: The subjects (n = 850), aged 54–66 years, were randomly sampled from the population register. A questionnaire survey, an otological examination, and pure-tone audiometry were performed. Results: Chronic middle-ear disease (both active and inactive) was the most common ear disease with a prevalence of 5.3%, while the prevalence of otosclerosis was 1.3%, and that of Ménière's disease, 0.7%. Noise exposure was reported by 46% of the subjects, and it had no effect on hearing among those with no ear disease or other otological risk factors for HI. Dark eye color and non-susceptibility to sunburn were associated with HI among noise-exposed subjects. Conclusions: Common ear diseases and other otological risk factors constitute a major part of the etiologies of HI among adults. Contrary to previous studies, noise exposure turned out to have only marginal effect on hearing among those with no otological risk factors.

Read More: http://informahealthcare.com/doi/abs/10.3109/14992027.2012.707334

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Mobile Healthcare Faces The Future [Infographic]

Mobile Healthcare Faces The Future [Infographic] | Audiology | Scoop.it

The Mobile Revolution continues to change how industry after industry goes about day-to-day business. Yet one industry has been surprisingly slow to embrace the benefits of mobile: healthcare. Many observers find that strange, since healthcare could clearly benefit from the power of smartphones and tablets attached to the cloud.


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Intersect ENT Enrolls First Patient in Clinical Study to Expand Access to ... - NASDAQ

Intersect ENT Enrolls First Patient in Clinical Study to Expand Access to ... - NASDAQ | Audiology | Scoop.it
Intersect ENT Enrolls First Patient in Clinical Study to Expand Access to ... NASDAQ MENLO PARK, Calif., Sept. 17, 2014 (GLOBE NEWSWIRE) -- Intersect ENT, Inc.
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Patient Engagement and SMS

Patient Engagement and SMS | Audiology | Scoop.it

It’s almost a cliché that providers need to reach patients where they want to connect, yet there is an existing option being underused.

No, it’s not mHealth applications – but it has demonstrated some “astounding” results.

 

“We tend to think about apps when we think about mobile, and apps are great,” said Travis Good, MD, CEO of catalyze.io, during the AHIMA Convention last Tuesday morning in Atlanta. “But there are simpler solutions we might think about when engaging patients.”

 

SMS, texting and e-mail are chief among those.

 

Patient “response and bill pay rates are completely and totally astounding. I mean I’m floored by it,” Good said. “Messaging is something we tend not to think about.”

 

Because of HIPAA restrictions, Good said, many doctors are also discouraged by SMS, but “HIPAA does allow patients to opt-in to receive SMS messages,” he added.

 

Although there are not many healthcare-centric SMS services right now, that’s changing. And based on preliminary results and the fact that so many patients have SMS-capable phones, that could change quickly. 

 

more at http://healthworkscollective.com/node/134701

  
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Hearing Review - University of Washington Scientists Developing a Vestibular Prosthesis

Hearing Review - University of Washington Scientists Developing a Vestibular Prosthesis | Audiology | Scoop.it
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Tinnitus Therapy From Widex, The Zen Therapy Protocols

Tinnitus Therapy From Widex, The Zen Therapy Protocols | Audiology | Scoop.it
Widex has recently introduced the Zen Therapy Protocols, Tinnitus Therapy involving the use of the Zen feature.
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Hearing Review - True Advances in Hearing Aid Technology: What Are They and Where’s the Proof? - January 2013 Hearing Review

Hearing Review - True Advances in Hearing Aid Technology: What Are They and Where’s the Proof? - January 2013 Hearing Review | Audiology | Scoop.it
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Scientists Identify Molecules In The Ear That Convert Sound Into Brain Signals

Scientists Identify Molecules In The Ear That Convert Sound Into Brain Signals | Audiology | Scoop.it
For scientists who study the genetics of hearing and deafness, finding the exact genetic machinery in the inner ear that responds to sound waves and converts them into electrical impulses, the la
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Principles of Digital Dynamic-Range Compression

This article provides an overview of dynamic-range compression in digital hearing aids. Digital technology is becoming increasingly common in hearing aids, particularly because of the processing flexibility it offers and the opportunity to create more-effective devices. The focus of the paper is on the algorithms used to build digital compression systems. Of the various approaches that can be used to design a digital hearing aid, this paper considers broadband compression, multi-channel filter banks, a frequency-domain compressor using the FFT, the side-branch design that separates the filtering operation from the frequency analysis, and the frequency-warped version of the side-branch approach that modifies the analysis frequency spacing to more closely match auditory perception. Examples of the compressor frequency resolution, group delay, and compression behavior are provided for the different design approaches.

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Distortion-Product Otoacoustic Emission Tests Evaluate Cochlear Function and Differentiate Cochlear and Vestibular Schwannoma

Objectives. (1) To investigate cochlear function in patients with acoustic neuroma by distortion-product otoacoustic emission tests and (2) to evaluate the utility of this method for identifying the nerve origin of acoustic neuroma

.
Study Design. Diagnostic test assessment.


Setting. Community hospital.


Methods. The study included 196 patients with unilateral acoustic neuroma who were surgically treated in our hospital between April 2008 and March 2011. In all patients, pure-tone audiometry and distortion-product otoacoustic emission tests were conducted before surgery, and tumor size was measured on magnetic resonance imaging.

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Hearing loss and PRPS1 mutations: Wide spectrum of phenotypes and potential therapy, International Journal of Audiology, Informa Healthcare

Hearing loss and PRPS1 mutations: Wide spectrum of phenotypes and potential therapy, International Journal of Audiology, Informa Healthcare | Audiology | Scoop.it

Objective: The purpose of this review was to evaluate the current literature on phosphoribosylpyrophosphate synthetase 1 (PRPS1)-related diseases and their consequences on hearing function. Design: A literature search of peer-reviewed, published journal articles was conducted in online bibliographic databases. Study sample: Three databases for medical research were included in this review. Results: Mutations in PRPS1 are associated with a spectrum of non-syndromic to syndromic hearing loss. Hearing loss in male patients with PRPS1 mutations is bilateral, moderate to profound, and can be prelingual or postlingual, progressive or non-progressive. Audiogram shapes associated with PRPS1 deafness are usually residual and flat. Female carriers can have unilateral or bilateral hearing impairment. Gain of function mutations in PRPS1 cause a superactivity of the PRS-I protein whereas the loss-of-function mutations result in X-linked nonsyndromic sensorineural deafness type 2 (DFN2), or in syndromic deafness including Arts syndrome and X-linked Charcot-Marie-Tooth disease-5 (CMTX5). Conclusions: Lower residual activity in PRS-I leads to a more severe clinical manifestation. Clinical and molecular findings suggest that the four PRPS1 disorders discovered to date belong to the same disease spectrum. Dietary supplementation with S-adenosylmethionine (SAM) appeared to alleviate the symptoms of Arts syndrome patients, suggesting that SAM could compensate for PRS-I deficiency

Read More: http://informahealthcare.com/doi/abs/10.3109/14992027.2012.736032

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Bilateral versus unilateral cochlear implants in children: Speech recognition, sound localization, and parental reports, International Journal of Audiology, Informa Healthcare

Bilateral versus unilateral cochlear implants in children: Speech recognition, sound localization, and parental reports, International Journal of Audiology, Informa Healthcare | Audiology | Scoop.it

Abstract

Objective: To compare bilateral and unilateral speech recognition in quiet and in multi-source noise, and horizontal sound localization of low and high frequency sounds in children with bilateral cochlear implants. Design: Bilateral performance was compared to performance of the implanted side with the best monaural speech recognition in quiet result. Parental reports were collected in a questionnaire. Results from the CI children were compared to binaural and monaural performance of normal-hearing peers. Study sample: Sixty-four children aged 5.1–11.9 years who were daily users of bilateral cochlear implants. Thirty normal-hearing children aged 4.8–9.0 years were recruited as controls. Results and Conclusions: Group data showed a statistically significant bilateral speech recognition and sound localization benefit, both behaviorally and in parental reports. The bilateral speech recognition benefit was smaller in quiet than in noise. The majority of subjects localized high and low frequency sounds significantly better than chance using bilateral implants, while localization accuracy was close to chance using unilateral implants. Binaural normal-hearing performance was better than bilateral performance in implanted children across tests, while bilaterally implanted children showed better localization than normal-hearing children under acute monaural conditions

Read More: http://informahealthcare.com/doi/abs/10.3109/14992027.2012.705898

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B2B Content for Customer Retention Tells a Different Story

B2B Content for Customer Retention Tells a Different Story | Audiology | Scoop.it

Customer retention calls for a different content strategy

 

SUMMARY: B2B marketers are paying more attention to customer retention and should adjust their campaigns to that specific purpose, Ardath Albee writes. Content marketing should encourage the embrace and use of the purchased product, and help customers find more value in it. Probe them for their expansion plans and potential problems with the product or service, and give even the smallest customers the attention they need and deserve.

 

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