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Legacy HIT isn't working: doctors, patients frustrated by costly information-sharing systems

Legacy HIT isn't working: doctors, patients frustrated by costly information-sharing systems | Doctor | Scoop.it

A Vancouver doctor has spoken out against a dysfunctional $258-million information-sharing system that is failing B.C. doctors.

 

“I have a patient who has a very serious heart condition and because of that he went to Eagle Ridge Hospital [in Port Moody],” said general practitioner Dr. Etela Neumann.

 

“Most of his records, if not all, are kept at St. Paul’s [in Vancouver], but because the [emergency room] physician had no access to them he ordered several tests that were already done a few weeks before and the patient was very frustrated.”

 

At the heart of Neumann’s complaint is B.C.’s physician electronic medical and health records system that has been under development since the mid-2000s and has so far cost $258 million.

 

On top of that cost is the Physician Information Technology Office, which has a budget of $108 million to roll out technology and support doctors using the doctor’s information-sharing system — dubbed EMR.

 

The Ministry of Health has acknowledged the implementation of the EMR system has been a costly challenge.

 

“Each health authority introduced computer systems and programs more than 10, 15 or even 20 years ago,” the ministry explained in a statement.

 

“These older systems were designed to improve service delivery in the local health authority and meet their business and patient needs at the time. The focus at the time was often not on sharing records or discharge information between the other health authorities.”

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Diagnosing the contemporary healthcare professional's digital habits
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Healthcare is getting better. Let's talk about what you can do to make it even better, faster.

Healthcare is getting better. Let's talk about what you can do to make it even better, faster. | Doctor | Scoop.it

Click on the link above to contact Andrew Spong, Managing Director, STweM Ltd.

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Study calls for doctors to consider editing Wikipedia

Study calls for doctors to consider editing Wikipedia | Doctor | Scoop.it

From the conclusion:

 

"In the Internet era, our role as doctors in guiding patients towards high-quality health information has expanded into the digital setting. It is difficult to make recommendations on an optimal approach to this complex and evolving environment. However, from this review, the potential inaccuracy of information on the Internet suggests some key areas in which doctors can contribute.

 

In the clinical setting, more time spent in discussion with patients on aspects of diagnosis and treatment may be a beneficial, individualised alternative to Internet information. For computer literate patients, guidance towards high quality, accurate web resources is a reasonable approach which may help patients to navigate the myriad of information available to them while promoting autonomy.

 

Becoming actively involved in editing and updating resources such as Wikipedia may also be an effective way to disseminate our knowledge to patients."

Andrew Spong's insight:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920473/

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Clinician use of social media when job hunting

Clinician use of social media when job hunting | Doctor | Scoop.it
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A doctor's prescription for social media, part 2

A doctor's prescription for social media, part 2 | Doctor | Scoop.it
As an experiment, I immersed myself in social media for the past 3 months. Social media has changed the way that I think about and practice medicine
Andrew Spong's insight:

The second entry in an insightful and well-written account of a clinician's experiences of healthcare professional social media use. Recommended.

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Why blocking social media is not the answer: a doctor's point of view

Why blocking social media is not the answer: a doctor's point of view | Doctor | Scoop.it

Edwin Kuys writes on the 'Doctor's Bag' blog:

 

"I am a strong proponent of open access to social media. I feel the decision to block staff access to e.g. LinkedIn or YouTube is often ill-advised, and it’s not beneficial to organisations in the long run.

 

Many times I’ve heard the following reasons for restricting social media usage at work: “We don’t want our staff to be distracted.” And: “They shouldn’t waste their time on social media.” Other reasons may include perceived cyber risks or the cost of excess data usage.

 

Any organisation that blocks social media sites may send out one or more of the following messages:

 

We don’t really understand what social media is all aboutWe don’t trust our staffEven though consumers are using social media for health purposes, we’re not interested

 

Admittedly, this is probably unintentional. In most cases decision makers are probably unfamiliar with social media and may see it as a threat.

Here are five reasons why health care staff should have access to LinkedIn, Twitter, YouTube, Blogs etc…Social networks are powerful learning tools for staffSocial media are increasingly used as health promotion tools (e.g. embedded YouTube videos)Shared knowledge accessible via social media will assist staff in finding answers and making better decisionsInteractions with peers and thought leaders increases work satisfaction (and will contribute to staff retention)Participating in social media and other new technologies will raise the (inter)national profile of an organisation"

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Showcasing physicians' bedside manners through micro websites

Screen the Doc recently launched an online tool that some healthcare officials say could change how hospitals and private practices reach prospective patients. The new recruitment and relations platform allows medical facilities to showcase physicians' bedside manners through micro websites called Virtual Patient Centers.

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3D printed skull replacement implanted for the first time

3D printed skull replacement implanted for the first time | Doctor | Scoop.it
A Dutch hospital has successfully performed the first operation replacing a patient’s skull with a 3D-printed version.
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“We can’t stop at giving patients access to their EHR; we have to make that digital experience meaningful”

“We can’t stop at giving patients access to their EHR; we have to make that digital experience meaningful” | Doctor | Scoop.it

Two Mississippi doctors'  shared their views on the need to integrate digital tools more effective into the doctor-patient relationship at SXSW recently:

 

Dr. Jennifer Joe:  “We have to be more innovative in bringing doctors and medical students into this digital age to improve doctor/patient relations and in academic medicine.” 


Dr. Ivor Horn: “We can’t just stop at giving patients access to their digital medical records; we have to make that digital experience meaningful to our patients"

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3-D printers make human tissue in push to create livers

3-D printers make human tissue in push to create livers | Doctor | Scoop.it

3-D printing used to construct everything from art to toys to spare parts for the space station may one day produce human organs at a hospital near you.

 

The 20-year-old technology uses liquid materials that become hard as they print out three-dimensional objects in layers, based on a digital model. Current medical uses are in dentistry, for hard-material crowns, caps and bridges, as well as prosthetics. Last year, a 3-D printer was used to create a structure from moldable polymer that replaced more than 75 percent of a patient’s skull.

 

Now, Organovo Holdings Inc. is using 3-D printers to create living tissue that may one day look and act like a human liver, able to cleanse the body of toxins. Drugmakers and cosmetic companies already plan to use 3-D printed human tissue to test new products. Eventually, the technology may help reduce organ shortages and cut transplant rejections as patients receive new organs constructed from their own cells.

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Researchers seek hints at patient attitudes in doctor jokes

Researchers seek hints at patient attitudes in doctor jokes | Doctor | Scoop.it

"Knock, knock"

 

"Who’s there?"


A bunch of researchers studying doctor jokes on Facebook, that’s who.

 

But it’s not all just for laughs. The Dartmouth Institute of Health Policy & Clinical Practice study published in the February edition of the Journal of Medical Internet Research is one of the first to look at social networking site conversations pertaining to health and medicine, according to a news release from the institute.

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3 laws of hospital health information technology implementation.

3 laws of hospital health information technology implementation. | Doctor | Scoop.it

Just in time for HIMSS, Ignacio Valdes MD, MS perspicaciously offers three laws of hospital health information technology implementation:

 

1) Implementers and salespeople who don't know what they are doing will always get a binding, multi-year contract first.

 

2) Hospital management and owners will always do the wrong thing.

 

3) Everyone will grossly underestimate the time, difficulty, and expense it takes to fully implement Health IT in a hospital.

 

Andrew Spong's insight:

Dripping with irony his post may be, but Dr. Valdes is on to something.

 

Commercial interests first, patient health outcomes a distant second -- if you're lucky.

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Health and social care: thinking differently about channel shift

Health and social care: thinking differently about channel shift | Doctor | Scoop.it

Over the last decade, the evidence has made it very clear that people who are not online are older, less educated, and more socially disadvantaged. Users of health and social care services are drawn heavily from these groups.

 

Whatever the cost savings to be made, health and social care managers have argued successfully that a significant proportion of their service users would simply not have access to the technology, or the necessary skills, to use online channels.

 

Things are changing however, and there is growing recognition that the time may now be right for the sector to start embracing digital working and channel shift with greater enthusiasm.

 

Technology has genuinely become available to almost everyone. Rapid take up of smartphones and tablets, and much greater access to free wi-fi and low cost broadband has meant that having no access to a PC, or affordable broadband is no longer the barrier it once was.

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23 and Me and Me.

23 and Me and Me. | Doctor | Scoop.it

Ronan Kavanagh MD MRCP (@RonanTKavanagh) writes:

 

"My patient is a middle aged professional, with no symptoms what so ever.

 

He is fit and healthy, a non smoker, has good teeth, eats well and has no family history of arthritis or autoimmune disease. So why is he seeing a rheumatologist?

 

He’s concerned about some results he has received from a genetic screening test. The test results suggest that his risk of developing two autoimmune diseases – rheumatoid arthritis and Scleroderma, conditions I frequently treat, is increased.

 

I’m at a slight disadvantage as this is the first time I’ve had has to counsel a patient in this situation.

 

There’s an additional complicating factor.

 

The patient is me."

Andrew Spong's insight:

Never less than a joy to read. You're following Ronan already? Ah. Of course you are.

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What are the three main gaps in digital health?

What are the three main gaps in digital health? | Doctor | Scoop.it

Arlen Meyers (@ArlenMD) presents a short video offering his view as to what the three main gaps are in digital health.

Andrew Spong's insight:

I agree with #1.

 

From my POV, #2 is a red herring (few are more than one degree away from HIT; we're in a transitional era; use savings from effectively deployed HIT to target hard-to-reach groups by other means)

 

#3 is only a 'digital health gap' insofar as it is an internal, structural issue exacerbated by legacy organisations' inability to reform, adapt, and redeploy resources. If they can't manage this, they'll perish anyway.

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Six robots already in use in hospital settings

Six robots already in use in hospital settings | Doctor | Scoop.it
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Beyond HIT: the modern healthcare CIO's responsibilities

Beyond HIT: the modern healthcare CIO's responsibilities | Doctor | Scoop.it
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To tweet or not to tweet: social media for physicians

To tweet or not to tweet: social media for physicians | Doctor | Scoop.it

Karen Sullivan Sibert, MD writes:

 

"Used wisely, social media can be valuable communication tools.


Here follows a brief guide to social media for physicians, admittedly subjective, with caveats included."

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A doctor's prescription for social media

A doctor's prescription for social media | Doctor | Scoop.it

"As an experiment,  I immersed myself in social media for the past three months.  I started this blog, joined Twitter, LinkedIn, Google+, bought a domain name, and posted on Facebook for the first time in years.

 

Even within this short period of time, I reaped tangible benefits: I interacted with top physicians from across the world, kept up with the  medical literature, participated in discussions with patients about how how rheumatic diseases affect their lives, joined webinars about improving the patient experience, and provided educational information to physicians and patients about autoinflammatory diseases, my clinical interest.

 

Social media has changed the way that I think about and practice medicine, and it’s only been a few months"

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Wilf ILIFFE's curator insight, April 5, 5:56 AM

No mention of the pharma industry, though.

Bettina Gifford's curator insight, April 6, 1:00 AM

A doctor's perspective about the benefits of social media involvement..

Javier Antonio Bellina's curator insight, April 8, 8:48 AM

Las ventajas de estar en Internet.

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IBM supercomputer Watson enlisted to help fight brain cancer

IBM supercomputer Watson enlisted to help fight brain cancer | Doctor | Scoop.it
Watson, IBM’s supercomputer that famously took on Jeopardy, is now taking on something a little less trivia-oriented – brain cancer. IBM is working with the New York Genome
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Medical Board of Australia to rewrite social media rules

Medical Board of Australia to rewrite social media rules | Doctor | Scoop.it
After weeks of fury from doctors, the Medical Board of Australia has finally conceded that its new social media rules are too confusing and need to be rewritten.
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Participatory medicine encourages partnership between patient and provider

Participatory medicine encourages partnership between patient and provider | Doctor | Scoop.it

Marc R. Katz, MD writes:

 

"I now ask all my patients, at the end of our visits, “Did I get it? Did I successfully answer your questions and address your fears?”

 

My hope is that they can now leave the appointment comfortable that all questions and concerns have been properly addressed.

 

I supply references, both text and web-based, all in an effort to help my patients become better informed and more active and engaged in their health."

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3-D printer creates transformative device for heart treatment

3-D printer creates transformative device for heart treatment | Doctor | Scoop.it

Igor Efimov, PhD, at the School of Engineering & Applied Science at Washington University in St. Louis and an international team of biomedical engineers and materials scientists have created a 3-D elastic membrane made of a soft, flexible, silicon material that is precisely shaped to match the heart's epicardium, or the outer layer of the wall of the heart.


Current technology is two-dimensional and cannot cover the full surface of the epicardium or maintain reliable contact for continual use without sutures or adhesives.

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Doctors, patients, and computer screens

Doctors, patients, and computer screens | Doctor | Scoop.it

Dr. David Blumenthal believes that “given its huge public health, research, safety and quality advantages, the digitization of health information is inevitable,” and he predicts that voice recognition and systems that enable patients and medical assistants to enter more data will transfer much of physicians’ digital burden.

 

Blumenthal also implied something that had occurred to me but that I’d preferred not to think about: part of my problem with computers is my age. Though I’m no Luddite, my younger colleagues are less troubled by screens than I am.

 

“For physicians of a certain generation,” Blumenthal told me tactfully, the current status of computers in medicine is “a painful interlude in an important historic process.”

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Top physician information sources by mobile device

Top physician information sources by mobile device | Doctor | Scoop.it
Top physician information sources by mobile device
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Could digital health make most medical devices obsolete?

Could digital health make most medical devices obsolete? | Doctor | Scoop.it

Brian Buntz writes:

 

Most medical devices will not be 'pure software'.

 

Rather:

 

The principal value added by most Class 2 and 3 medical devices, which are not mechanical things like structural prosthetics (e.g., knee replacement) or physical accessories (e.g., laser hand piece), is increasingly contained in the algorithms.
 The critical electro-mechanical infrastructure for algorithms, which used to be quite dear, has now become nearly a commodity with the proliferation of embedded systems for consumer use. There just never was sufficient volume for this to happen with just military and industrial use. The exact same thing is happening with sensors and sensor fusion techniques that permit extracting greater value from the sensed signals.
 The software tools, while still quite dear, for creating high reliability software systems are also coming down in price (sometimes to the price of almost free—check out www.sourceforge.com) and soon will be within reach of sole practitioners like myself.
 The ability to inexpensively create complex electro-mechanical parts (including 3-D printed circuit boards) using such techniques such as additive manufacturing, and within the decade self-organizing nanoscopic entities, will shift the real intellectual property values to algorithmic creations and innovations (including those algorithms driving the printers and nanobots). Math, physics, and high-quality software engineering will gain high perceived value!
 The forthcoming crop of healthcare professionals (physicians, nurses, pharmacists, etc.) grew up tech-savvy prior to choosing their profession–they will expect sophisticated HIT and will be greatly dissatisfied when they do not have it or have to struggle with it (e.g., HF/UX issues).
 Economic and competitive pressures in healthcare delivery, combined with the parallel new crop of tech-savvy managers and an emphasis on collective purchasing, will put downward pressure on medical device prices—meaning, at least from my perspective, that the cost of goods sold needs to decrease – which brings us back to the earlier point that the marginal cost of duplicating software is very low and the fixed cost, if distributed over a very large number of copies, can be made quite low as well.
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