MORE THAN 200 DESIGN TEAMS PARTICIPATED IN THE HEALTH DESIGN CHALLENGE, A COMPETITION TO REDESIGN PATIENT MEDICAL RECORDS. SOON, 6 MILLION VA PATIENTS WILL SEE THE BENEFITS.
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These are the slides from my talk at the 4th Annual Putting Patients First Conference in Mumbai.
If god were to manifest the world using technology, he would first create something like social media. Conceptually provide technology with the ability to understand the thoughts of a population
Further, anyone can setup an online site related to a treatment, a disease, a doctor, a drug , a concept or anything and see it grow into a popular site which in effect is simply the manifestation of a community which exists/ed but which no one ever knew of.
Large computerised patient databases provide a useful source of real life observational data, and the General Practice Research Database (GPRD) has been successfully used to generate descriptive epidemiology data in chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD) and asthma from a large group of UK primary care practices.
Historically the limitations of the GPRD for clinical research were a time gap between GP data capture and availability for the researcher and limited links to other healthcare databases, although these are currently being addressed with the development of the Clinical Practice Research Datalink (CPRD) and in ongoing pilot work for Phase 4 pragmatic clinical trials . The use of electronic medical record (EMR) data in health research is a key objective in the Department of Health‟s national research strategy ]. EMR is increasingly adopted to support both efficiency and quality of patient care and to facilitate clinical research. Several studies have described the design and implementation of EMR, electronic data capture (EDC), data extraction and EMR retrieval systems to enable accurate and efficient data entry for clinical research to be performed on-site in real time .
In asthma and COPD, the application of EMR retrieval systems would enable the monitoring of large patient populations to support evaluation of comparative effectiveness, safety, and health care resource utilisation (HRU) of treatments in a real life setting.
Conclusion: Apollo and SIR data extracts into NWEH-LDB showed a high level of concordance for asthma and COPD patients. Longitudinal data analysis characterized the COPD and asthma populations in Salford including medications prescribed and health care utilisation outcomes suitable for clinical trial planning
Access the PDF at http://www.biomedcentral.com/content/pdf/s12911-015-0132-z.pdf
Although wearable devices have received significant attention for their ability to track an individual’s physical activity, most smartphone applications are just as accurate, according to a new research letter in JAMA.
The study tested 10 of the top-selling smartphone apps and devices in the United States by having 14 participants walk on a treadmill for 500 and 1,500 steps, each twice (for a total of 56 trials), and then recording their step counts.
Led by researchers at the Perelman School of Medicine and the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, this study is a follow-up to a recent JAMA viewpoint suggesting that there’s little evidence that wearable devices alone can change behavior and improve health for those that need it most.
Google is changing the way it displays search queries to pull medical facts directly into its results.
The medical information is being added to the company’s Knowledge Graph, which underpins Google’s instant search results and powers Google’s Now personal assistant and app. It will allow health questions to be answered directly, without a user having to click.
Google already does this with dictionary definitions, schedules for big sporting events and Wikipedia extracts for famous people. Knowledge Graph is essentially a built-in encyclopaedia, which pulls in facts, data and illustrations from various sources.
One in 20 searches on Google are health-related, according to the company. “We’ll show you typical symptoms and treatments, as well as details on how common the condition is – whether it’s critical, if it’s contagious, what ages it affects, and more,” said Prem Ramaswami, a product manager for Google’s search.
The future of health looks a lot like the fitness tracker you might already wear on your wrist or your waistband.
But instead of just keeping tabs on your activity level, high-tech sensors embedded throughout your home, your car and maybe even under your skin will keep tabs on your every waking moment.
And your sleeping moments too.
"A whole new day is coming," said Dr. Eric Topol, a cardiologist and director of the Scripps Translational Science Institute in La Jolla, considered a pioneer in the field of digital medicine.
This near-continuous data dump will revolutionize our healthcare system, Topol predicted, and will lead to micro-personalization of our diets, workouts, homes and even medical treatments.
The upshot, he said, is that this data onslaught puts control of your health back where it belongs: with you.
In many ways, the datafied future is already here, as much of that data are available but not yet used. The challenge will be to gather information from multiple sources and present it in a way that inspires more healthful activity and doesn't drive users to hypochondria.
Does your fitness tracker, for instance, motivate you to move 10,000 steps a day over the long run? But what if it alerted you that on days when you get 30 minutes less sleep than usual you tend to miss your goal? That might motivate you to get more sleep,.
Gradually, both will become integrated across the continuum of care. The reality is that, mHealth has succeeded and it has emerged as the winner and is changing the rules of healthcare.
A mhealth app (mobile based application) for managing diabetes is now US FDA approved, and has been allocated a ‘drug code’, which means that doctors can now prescribe an mHealth app in a similar manner as medicines ( drugs) and this will be reimbursed by the insurance companies. Now mHealth apps have the same status as drugs in the United States !
As patients become familiar with medical records and clinical notes, they consider new opportunities and risks. Some say they have become more careful about what information they share with clinicians, and some ask for more control over access to their information.
Providers are experimenting with strategies that help patients protect their privacy with regard to mental health, sexual function, suspected abuse, or other sensitive topics. And though family caregivers may find that reading notes improves their understanding of care plans and reduces stress, it's a complex task to establish separate proxy access based on patients' preferences about who gets to see what.
As transparent practice evolves, it's impossible to predict how much patients may stray from long-standing conventions. Portals afford patients secure access to their information, and doctor–patient confidentiality remains undisturbed.
But patients' attitudes toward privacy may change as online access allows them to share documents, including notes. A third of patients in the OpenNotes study expressed concern about privacy, but more than one in five shared a note with others who could clarify meanings, offer clinical insights or second opinions, or — for those participating in the patient's care — improve their own knowledge. Indeed, some patients may choose to post their providers' progress notes on Facebook, Twitter, medical forums, and other social media, potentially exposing clinicians to public scrutiny and crowd-fueled praise or criticism.
As a regulated industry, many healthcare organizations have avoided the use of social media, and have even tried to squelch its use by their employees. However, some healthcare providers are beginning to realize that there are opportunities to serve the public, patients and physicians, all while building awareness and enhancing their brand.
Who Is Using Social Media?
Patients, who are already active social media users, consider themselves part of a tribe and tend to trust others on social media more than other sources. It only makes sense that they will use social media to connect with each other to share their experiences with both rare and common disease and health issues.
Physicians can use social media to network professionally with colleagues and peers and to share medical knowledge within the medical community. Some doctors also believe that the authenticity of social media can drive better quality of care.
In short, social media is a platform where the public, patients and healthcare professionals can communicate about health issues and possibly improve health outcomes. However, as the healthcare industry slowly begins to embrace social media, the legal and risks of non-compliance with rules and regulations have never been higher.
Twitter can serve as a dashboard indicator of a community’s psychological well-being and can predict county-level rates of heart disease, according to new research published in Psychological Science, a journal of theAssociation for Psychological Science.
Previous studies have identified many factors that contribute to the risk of heart disease, including behavioral factors like smoking and psychological factors like stress.
Researchers from the University of Pennsylvania demonstrated that Twitter can capture more information about heart disease risk than many traditional factors combined, as it also characterizes the psychological atmosphere of a community.
The findings show that expressions of negative emotions such as anger, stress, and fatigue in the tweets from people in a given county were associated with higher heart disease risk in that county. On the other hand, expressions of positive emotions like excitement and optimism were associated with lower risk.
The results suggest that using Twitter as a window into a community’s collective mental state may provide a useful tool in epidemiology:
HealthTap published a survey of the top physician-rated apps for both iOS and Android, and breaks it down into 30 separate categories.
HealthTap founder and CEO Ron Gutman said the company's goal is to give clinicians and consumers a guide to choosing apps that have been approved by doctors, rather than resorting to the user ratings found in app stores (HealthTap's AppRx app, by the way, has a healthy 4.72 star rating in the Apple App Store, he said). The apps are judged on three standards – ease of use, effectiveness and medical accuracy, validity and soundness. They're not given a number rating, but are ranked solely based on how many doctors would recommend them.
Top 10 Health and Medical Apps for Android
1. Weight Watchers Mobile (Weight Watchers International)
2. White Noise Lite (TMSoft)
3. Lose It! (FitNow)
4. First Aid (American Red Cross)
5. RunKeeper – GPS Track Run Walk (FitnessKeeper)
6. Emergency First Aid/Treatment (Phoneflips)
7. Instant Heart Rate (Azumio)
8. Fooducate – Healthy Food Diet (Fooducate)
9. Glucose Buddy – Diabetes Log (Azumio)
10. Pocket First Aid & CPR (Jive Media)
Top Health and Medical Apps for iOS
1. Calorie Counter and Diet Tracker (MyFitnessPal.com)
2. Weight Watchers Mobile (Weight Watchers International)
3. Lose It! (FitNow)
4. White Noise Lite (TMSoft)
5. First Aid (American Red Cross)
6. Runkeeper (FitnessKeeper)
7. Stroke Riskometer (Autel)
8. Emergency First Aid & Treatment Guide (Phoneflips)
9. Instant Heart Rate (Azumio)
10. Fooducate (Foducate)
A new report finds that while nearly all physicians have a smartphone, few said they would use their personal phone to access electronic health records. Meanwhile, 70% of physicians said hospital IT organizations are not making adequate investments in physician mobile computing and communication.
The report found that doctors prefer to use consumer text messaging for clinical communication over secure messaging applications because it is simpler to do so.
Eighty-three percent of respondents expressed frustration over using an EHR system for clinical communication due to:
However, while 96% of physicians said they use smartphones, only 10% of those who do so said they would use them to access EHRs.
It would have been surprising if the report found it otherwise. The majority of todays EHR's are still clunky and have unfriendly workflows. Mobile users (including doctors obviously) will require interfaces which are clean and easy to navigate, and the mobile usage workflow must be extremely simple.
With a number of firms promoting their newer shiny EHRs with separate Mobile Specific versions , it will be interesting to see the results of such a study 24 -36 months down the line.
As practices look to integrate newer and hopefully advanced technologies to help them reduce readmission rates and improve outcomes, there is a lot to consider.
Buzzwords abound, like big data and coordinated care, but what those things actually mean vary largely from one place to the next.
ECRI Institute’s 2015 Top 10 Hospital C-Suite Watch List discusses a blend of novel, new, and emerging technologies that will demand attention and planning over the next 12 to 18 months, plus important issues and programs affecting care processes and delivery in 2015 and beyond.
Can we standardize and personalize healthcare at the same time? James Dias, CEO and Founder of Wellbe shares how we can do both to improve patient care.
Usually when personalization is mentioned in the world of healthcare thoughts jump to genetics and personalized medicine with custom cancer drugs and medical devices. However, there is another type of personalization that can be applied to healthcare, to make each patient feel like an individual, rather than just “one of the masses.”
The world of ecommerce discovered the value of personalized online experiences a decade ago and the additional revenue/branding/loyalty that can be generated from it. For example, the NikeiD website offers customers the ability to customize their own shoes. Who can forget the “Elf Yourself” campaign from Office Depot, where you could stick your friends’ and family’s faces on to happy dancing elves? With the new year upon us, fewer people are opting to buy regular old glossy calendars when a dozen photo sites will let you make a custom one from your personal photos.
Personalization is all around us, from the recommendation engines of Netflix and Amazon, to the custom radio stations you can create on Pandora. Smart programs have figured out what’s relevant to each of us and help filter the signal from the noise in today’s massive universe of information. As consumers, we engage and respond much more positively to these personalized experiences, which encourages loyalty and repeat business.
The psychology of personalization shows that engaging the customer in the process helps build a psychological and emotional attachment to their purchase. In addition, increasing customer participation boosts feelings of control and ensures satisfaction at the point of sale.
Similarly, by offering a personalized digital healthcare experience, we can increase patients’ ownership of their health and outcomes. Often it seems that patients feel they have no control over their outcomes, when actually the opposite is true. When they feel like active participants in their health journeys, it is more likely they will achieve the outcomes they desire, and they will feel like they got better value for their dollar.
more at http://hitconsultant.net/2015/01/19/standardization-vs-personalization-can-healthcare-do-both/
New survey data from digital health agency Klick Health shows that diabetes patients who use digital tools to manage their health also feel healthier.
Klick Health employed Survey Sampling International (SSI) to poll 2,000 American adults with diabetes either online or via the telephone.
Based on responses about how they use technology to manage their health, they segmented the group into three categories: those who manage their health daily or weekly with integrated digital technologies (integrators), those who go online to seek health information on a monthly basis (seekers), and those who don’t use the internet to manage their health at all (traditionalists).
The integrators group, the true digital health users, made up just 18 percent of the sample, but 13 percent of integrators reported being in excellent health. Seekers made up 47 percent of the sample and 4 percent of seekers said they were in excellent health. Finally, the remaining 35 percent were traditionalists, and only 2 percent of that group reported being in excellent health.
Because it’s a survey based on self-reported health status, the data doesn’t prove that connected patients are actually healthier than non-connected patients. But it does provide evidence that either they’re healthier or they believe they’re healthier, which is significant in and of itself.
Nineteen percent of patients reported using mobile technology for a health-related activity. Of these, most wanted more data-driven interactions with their doctors. Two-thirds said they would like an app to remind them to take their medication, 75 percent wanted apps to connect them with their doctors, and 78 percent were open to sharing personally-collected health data with their doctors.
Overall, 80 percent of the mobile connected group were interested in having an app recommended to them by their doctor.
Whether newly insured, seeking care for the first time as an adult or disgruntled with a current provider, prospective patients represent golden opportunities for healthcare systems, hospitals, physicians and practices. Although organizations go to great lengths to attract local patients, many overlook the power of online physician profiles to boost their organizations’ local visibility and enhance the patient experience. These three step will show how physician profiles enhance the patient experience, how organizations can create successful physician profiles, and how timely real-world content can help.
Step 1 – Enhancing the patient experience
While two-thirds of consumers in a recent Strategy & survey of 2,339 U.S. residents indicated they were satisfied with their core healthcare benefits and 63% were satisfied with the cost and quality of their healthcare, less than half (40%) were satisfied with their overall experience shopping for healthcare and/or insurance.
Step 2 – How to create successful physician profiles
Search engine algorithms and their decision-making processes change often, but certain concepts and tactics remain consistent. Follow these steps to create successful physician profiles and ensure a strong digital presence, especially within local search results and on mobile devices.
It is important that all online hospital, practice and physician listings are accurate and up-to-date. All content contained in physician profiles should be current and fresh. Address and phone numbers should absolutely be correct and current, but this is just the beginning. Profiles should also contain current information regarding services offered, hours of operation, degrees, experience, accepted insurance plans, languages spoken and more. All of this information should be maintained and updated across all listings on owned and third-party sites.
Step 3 – Leverage timely real-world content to boost relevance and traffic
Being attentive to timely high profile health stories occupying the minds of current and prospective patients can pay big dividends for organizations seeking to stay top of mind and increase traffic to their websites and facilities by providing valuable information to the public. The simplest and most effective way to get started on this initiative is to align content and messaging with relevant high volume search terms.
Once physician profiles are in place and optimized for success, identifying and catering to timely concerns on the minds of current and prospective patients can take these patient acquisition tools to new heights. With few organizations effectively capitalizing on this local search marketing fundamental, healthcare organizations that embrace the opportunity often realize significant and prompt results.
At @plus91 we have been advocates of Online Profile Creation and Effective Management for All Physicians, Surgeons, Clinics and Hospitals as we believe its the foundation for providing the widespread benefits possible from Digital Health. Here is a post I did on the topic which was part of a book which came out a few years back.
Google Translate has only 57.7% accuracy when used for medical phrase translations and should not be trusted for important medical communications.
However, it still remains the most easily available and free initial mode of communication between a doctor and patient when language is a barrier.
Although caution is needed when life saving or legal communications are necessary, it can be a useful adjunct to human translation services when these are not available.
Read the research paper below which formed the above conclusion.
Communication is the cornerstone of medicine, without which we cannot interact with our patients. The General Medical Council’s Good Medical Practice states that “Doctors must listen to patients, take account of their views, and respond honestly to their questions. However, we still often interact with patients who do not speak the local language.
In the United Kingdom most hospitals have access to translation services, but they are expensive and often cumbersome. A complex and nuanced medical, ethical, and treatment discussion with patients whose knowledge of the local language is inadequate remains challenging. Indeed, even in a native language there is an element of translation from medical to lay terminology.
We recently treated a very sick child in our paediatric intensive care unit. The parents did not speak English, and there were no human translators available. Reluctantly we resorted to a web based translation tool. We were uncertain whether Google Translate was accurately translating our complex medical phrases. Fortunately our patient recovered, and a human translator later reassured us that we had conveyed information accurately.
We aimed to evaluate the accuracy and usefulness of Google Translate in translating common English medical statements.
Ten medical phrases were evaluated in 26 languages (8 Western European, 5 Eastern European, 11 Asian, and 2 African), giving 260 translated phrases. Of the total translations, 150 (57.7%) were correct while 110 (42.3%) were wrong. African languages scored lowest (45% correct), followed by Asian languages (46%), Eastern European next with 62%, and Western European languages were most accurate at 74%. The medical phrase that was best translated across all languages was “Your husband has the opportunity to donate his organs” (88.5%), while “Your child has been fitting” was translated accurately in only 7.7% (table⇓). Swahili scored lowest with only 10% correct, while Portuguese scored highest at 90%.
There were some serious errors. For instance, “Your child is fitting” translated in Swahili to “Your child is dead.” In Polish “Your husband has the opportunity to donate his organs” translated to “Your husband can donate his tools.” In Marathi “Your husband had a cardiac arrest” translated to “Your husband had an imprisonment of heart.” “Your wife needs to be ventilated” in Bengali translated to “Your wife wind movement needed.”
Google Translate is an easily available free online machine translation tool for 80 languages worldwide. However, we have found limited usefulness for medical phrases used in communications between patients and doctor.
We found many translations that were completely wrong. Google Translate uses statistical matching to translate rather than a dictionary/grammar rules approach, which leaves it open to nonsensical results.
Biogen Idec has partnered with Google X, Google’s business unit for long-term “moonshot” projects, to study outside factors that might contribute to the progression of multiple sclerosis (MS), according to a report from Bloomberg.
Using de-identified patientdata from its Down Syndrome Registry, theNational Institutes on Health has launched a subsite of its DS-Connect, creating a web portal for approved professionals that are planning clinical studies or recruiting patients to generate new research.
The NIH effort with Down Syndrome is intended to increase understanding of the disease and how to treat accompanying health problems, including the risk of autism, issues with hormones and glads, hearing loss, vision problems and heart abnormalities, officials said.
Researchers can view information on a participant’s health history, including symptoms, diagnoses and other medical information.
If approved for a higher level of access, researchers can perform customized searches of the data, proposed new survey questions or identify a pool of patients for clinical trials. The registry will coordinate requests for the latter with eligible participants who have indicated a willingness to enroll.
"Although computers and EHRs can facilitate and even improve clinical documentation, their use can also add complexities," according to a new paper from the American College of Physicians, which offers its take on usage strategies and better system design.
"In the past decade, medical records have become increasingly synonymous with electronic health records," write the authors of the new report, "Clinical Documentation in the 21st Century," published in the Annals of Internal Medicine.
In the not-too-distant future, EHRs – and the clinical notes contained therein – will evolve: "Existing technology, such as registries, portals, connected home monitoring devices and provider- and patient-controlled mobile devices, as well as technology not yet in use or even built, is likely to integrate with or possibly even replace the EHR (as currently conceptualized) as a primary vehicle for viewing and recording clinical documentation," they write.
A majority of U.S. residents are willing to use an online video for a physician visit, according to a Harris Poll survey, MobiHealthNewsreports.
The survey, which was commissioned by telehealth company American Well, collected responses from 2,019 U.S. adults ages 18 and older in December 2014.Survey Findings
Overall, the survey found about 64% respondents were willing see a doctor via an online video consult.
Of those, 61% listed convenience as a factor.
The survey found respondents' willingness to switch to an online physician visit varied by age and the number of years they had seen their doctors (Pai, MobiHealthNews, 1/21). The survey showed:
However, about 88% of respondents said they would like to select the physician for a video visit rather than be randomly assigned one
Consumers are immersed in digital communication; it's time for traditional health care organizations to join them.
In just the past few years, the changes in how we communicate with one another and process information are nothing short of amazing.
Between 2010 and 2013, the total amount of time Americans spent online increased 83 percent. In that same period, time spent on smartphones more than tripled, while time spent on tablets increased tenfold. American smartphone owners between the ages of 18 and 24 sent and received an average of 3,853 texts per month each in 2013. As great as that volume is, it has been overtaken by the number of messages sent via apps such as WhatsApp and SnapChat. Digital media has even surpassed the venerable favorite, television, in the share of time that adults spend with media each day.
In no aspect of life is communication more important than in health care. Effective communication between patients and caregivers can be the difference between satisfaction and dissatisfaction, wellness and sickness, comfort and suffering, even life and death.
A large body of evidence shows the importance of effective communication between patient and caregiver in diagnosis, treatment selection, patient adherence to treatment regimen, treatment monitoring, healthy behavior and patient satisfaction. Communication before and after treatment — choosing providers, making appointments, paying for services — is also a critical component of consumer satisfaction and business success.
To manage communication, health care organizations have established and carefully maintained processes for when, where and in what form patients and providers exchange information.
Growing Momentum for Change
Innovative competitors are well-aware of the gap between modern modes of communication and the methods used by legacy health care organizations, and they are actively exploiting that gap. Companies like Teladoc, MD Live and Carena offer access to a doctor 24 hours a day, seven days a week via videoconferencing, phone and email. At upstart primary care company Iora Health, the technology platform allows patients to read and submit notes on their medical record. And Apple, Google and Samsung are all developing platforms to aggregate health-related apps.
New patient engagement trends from TechnologyAdvice Research reveals digital engagement is a growing factor in how patients choose healthcare providers.
Quality of care has long been a primary factor in choosing a healthcare provider, but convenience and communication are also becoming key considerations for patients. Still, many physicians do not appear to be offering the digital engagement services that can meet those demands.
According to a new nationwide survey conducted by TechnologyAdvice Research, a majority of patients (60.8 percent) said digital services like online appointment scheduling and online bill pay are either “important” or “somewhat important” when choosing a physician. However, when asked what services their current physician provides, less than one-third of patients indicated they have access to either online bill pay, online appointment scheduling, or the ability to view test results and diagnoses online, which are the top three services that patients report wanting the most.
“Primary care physicians are reporting some of the highest rates of EHR adoption to comply with government regulations and to receive incentives from Meaningful Use, but a significantly lower number of patients claim to have access to these patient portal services,” said TechnologyAdvice Managing Editor Cameron Graham, who authored the survey. “The issue here may not be implementation of digital services, but instead a lack of patient awareness. If physicians are offering these in-demand digital services, a more proactive approach to promoting them is needed and could create an advantage in attracting and retaining patients.”
- If providers wish to gain an upper edge in attracting new patients (especially younger ones), and in retaining their existing patients, they should invest in a fully featured patient portal system. For many primary care physicians this should not be difficult. Most comprehensive EHRs include patient portal features, and dedicated patient portal vendors are making strides in integrating with third-party systems. In particular, prioritizing systems with intuitive online appointment scheduling, online bill pay functionality, and online test results could provide a significant draw for new patients.
- For practices that already have patient portal systems, they should dedicate resources to making sure their patient populations are informed of the existence of such services. They should also consider prominently featuring these services in their advertising and on their websites. When orienting new patients to their practice, providers need to have a plan for walking patients through the initial portal set-up requirements and making sure they understand the features available to them.
-For particularly tech-savvy practices, a dedicated smartphone app could help set them apart, and attract younger individuals.
Everyone loves the idea of strapping a smartwatch to their wrist and using it to get a bit healthier, but there's a fine line between casual wearables and serious medical devices. It's an important distinction, since while the former can be sold without any sort of oversight, the latter is rightly covered by the FDA's regulations. Since the most recent batch of fitness wearables could be blurring the borders somewhat, the agency has decided to make its thinking on the subject a little clearer.
The agency has published a draft guidance note that, as yet, isn't legally binding and requests opinions from the public. As far as it's concerned, "general wellness devices," i.e. watches that vaguely encourage people to get fitter, aren't any sort of risk to the public. This means that your Fitbit is okay to tell you to go for a walk, your Aura can coach your sleeping and Lumosity can pretend to make you smarter without any worries. Mostly the FDA is concerned with risk, and there isn't much risk if your smartphone tells you to lay off the burgers one every now and again.
Legislation that incorporates psychiatric care into the acute-care spectrum and extends EHR incentives to behavioral health facilities has been proposed for going on five years now.
A show of hands: Who believes depression or bipolar disorder have no impact on the severity and treatment of a patient’s diabetes and COPD?
It’s an idea no practicing physician would support.
Yet time and again, we act as though mental illness and care can be kept separate from physical ailments.
Take Meaningful Use (MU), for example. The federal government believes healthcare must move into the digital age and is willing to pay hospitals to buy computer systems and electronic health records (EHRs).
But the financial rewards of demonstrated MU only extend to acute care hospitals and clinics, not psychiatric facilities, as though human health can be partitioned and compartmentalized.
While treating patients holistically has been accepted clinically for decades, some behavioral health advocates are turning up the pressure now to finally also bring behavioral health IT into the digital age.
Government health IT leaders say electronic health record systems can expand information sharing and help public health responders fight the spread Ebola and future viruses.
While the United States avoided a public health crisis from the Ebola virus, the possibility of an epidemic at home got government health IT leaders thinking about how electronic health records might be used to expand information sharing and help public health responders fight the spread of Ebola and future viruses.
There are significant hurdles to clear before the EHRs used in clinical care will be able to really help state, local and federal health officials track and respond to fast-moving outbreaks in real time, according to those at recent Health IT Policy Committee meeting on the potential for using EHRs to fight epidemics.
The problem of interoperability and data transfer between EHR systems, medical laboratories and public health databases is one big issue. More broadly, there is a lack of what experts call "bidirectionality" between health records, preventing health officials – either for technical or privacy reasons – from accessing individual patient records.
Ultimately, broader use of EHRs to detect and respond to epidemics will require changes in technology. The passive surveillance of patient EHRs using analytic tools could give greater velocity to detecting not just viral disease outbreaks, but environmental risks, contaminated food and medicine as well as other large-scale health problems that are clustered geographically or in certain demographic groups.
That’s not to say epidemiology is lacking in high-tech approaches. New York City, for example, was able to use cell phone location information and subway fare card data to conduct contact tracing on individuals that may have come into contact with the Ebola virus while traveling. However, aggregating that information, and making it available at scale through an EHR platform, appears to be a long way off.
A team of researchers out of Duke University recently announced they’ve grown human skeletal muscle in a dish. The muscle responds to electrical impulses, biochemical signals, and drugs just like muscle tissue in our bodies.
It’s hoped that in the future such lab-grown tissues might serve as a way to test new drugs and study diseases outside the human body without risking a patient’s health. They might also be used to provide more personalized therapies.
“We can take a biopsy from each patient, grow many new muscles to use as test samples and experiment to see which drugs would work best for each person,” said Nenad Bursac, associate professor of biomedical engineering at Duke and a lead researcher on the study.
Bursac and Lauran Madden, a postdoctoral researcher in Bursac’s laboratory, grew the muscle tissue by first adding “myogenic precursors,” a kind of proto muscle cell, to a three-dimensional scaffolding and nutrient gel in a dish. As the cells matured, they lined up and formed working muscle fibers (shown here at the top of the page).