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The ways in which technology benefits healthcare
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2012: About 62 percent of physicians use tablets

2012: About 62 percent of physicians use tablets | healthcare technology |

About 62 percent of physicians in the United States are now using tablets, according to the most recent data from Manhattan Research. Most of these physicians are using iPads and about half of all tablet-toting physicians use the devices at the point of care, the research firm found. What’s more, physicians who use smartphones, tablets, and computers tend to spend more time online on each device than those physicians who only have two of those devices.


The research firm polled more than 3,000 physicians in the US for its annual Taking the Pulse survey. One of the more surprising findings of the survey: Adoption of physician-only social networks stagnated year-over-year. Also, more than two-thirds of physicians said they use online video to keep up to date with clinical information.


“Physicians are evolving in ways we expected — only faster,” Monique Levy, Vice President of Research at Manhattan Research stated. “The skyrocketing adoption rates of tablets alone, especially iPads, means healthcare stakeholders should revisit many of their assumptions about reaching and engaging with this audience.”


In May 2011 Manhattan Research published survey results that found about 30 percent of physicians in the US used iPads to access EHRs, view radiology images, and communicate with patients.

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iPad Mania in Healthcare May Be Exaggerated

In all my years writing about healthcare and technology, I’ve never seen such a storm of enthusiasm over a new medical device. If the newspaper and blog coverage is any indication, we have no less than a moral duty to give an iPad to every practicing physician, stocked with a variety of the coolest medical apps.


In fact, Apple itself has jumped on the bandwagon, with its most recent iPad2 commercials displaying medical apps.


This, of course, has serious implications for EMR developers. If the iPad is eclipsing even the desktop and smartphone as a primary means of accessing medical information, their focus will have to shift from a traditional client-server model — and perhaps even existing SaaS options — to one which is more modularized. Their assumptions about users’ interaction with their interface will need to be different as well.


The thing is, despite all of this discussion, I’ve seen no stats to back up the notion that even tech-friendly doctors see iPads as indispensable.

Where the iPhone (or at least smartphones generally) are concerned, sure, there seems to be plenty of research documenting that most physicians rely on them.


But while there’s lots of anecdotes circulating about the iPad’s central future in medicine, none of the research firms covering the healthcare industry seem to have documented this trend.


What’s more, as a consumer whose family sees a lot of specialists — a few of us have chronic illnesses — I’ve never seen an iPad in anyone’s hands. Walk into a coffee shop in the prosperous D.C. metro suburbs where I live, and sure, at least one consumer will have one.


But in DC medical offices, not so much.

Now, don’t get me wrong, if I were a product manager with an EMR vendor, I’d create an iPad interface and trumpet its existence to the world — it makes marketing sense if nothing else. One vendor which has already taken this tack is DrChrono, which prominently advertises the iPad version of its free EMR.


Regardless, I’m still waiting to see more evidence that the buzz around the medical iPad is more than just the expertly-crafted legends Apple creates around its products. (Should we sense some Pixar magic here?) Anyway, just because everyone says something’s cool doesn’t mean it is. I mean, we learned that in high school, didn’t we?

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Social Media & Healthcare: Q&A with MD Anderson

As social media moves into more regulated industries such as healthcare, it is refreshing to see a leader in healthcare industry adopting early and successfully. Healthcare is moving and evolving; the two-­‐way relationship between caregivers and patients is alive and well in the social space. In this Q&A interview, Amy Howell discusses social media strategy and practices in the healthcare field with Lucy Richardson & Jennifer Texada of MD Anderson Cancer Center, one of the world’s leading cancer centers.


MD Anderson began in 2006 with YouTube, on the recommendation of an agency regarding SEO back when Google was about to index YouTube listings. A few months later, MD Anderson staff noted Mayo Clinic and Cleveland Clinic using social media in interesting ways. MD Anderson then launched Twitter and Facebook in March of 2007 and has been going strong ever since.

“We went from SEO to meeting patients and family members where they were,” Texada recalls. “One of the initial things we realized is that when patients get cancer diagnosis, the first thing they do is they get online and search. Being MD Anderson, we needed to be everywhere to meet patients where they were with quality, accurate information.”


How did you overcome legal?


“It wasn't easy. When we established the YouTube channel, we had to beg our IT division to unblock,” Texada remembers. “We had to explain that we were posting content for patients about treatment, care and conditions and that we needed to see what the patients were talking about.


If our teams couldn't see it, we couldn't help.”
The MD Anderson IT division had not blocked Facebook and Twitter, so able to access the sites, the communications team was able to begin education efforts and get a policy in place.


“We were so early and successful that we didn't have the legal and management argument,” said Texada. “Policy is really strict and understanding HIPAA is vital; we err on side of caution and are very conservative. When interviewing a patient, you must have all the forms signed and prepared prior to posting any content.” Over the years, regulated industries have learned that being conservative is key to successful campaigns and strategies.


What are your uses for Social?


Engagement, customer service, simple questions—people expect a certain level of service. One of most important uses of a website is as a hub for content. Then, use social media to direct traffic to the content on your website.

“If an airline can get on Twitter and use it for corporate social responsibility (CSR), a hospital system can too. We think that it is a must,” said Richardson.


“The connections we have made through Twitter have been amazing for us. We have been able to enhance our program through real contacts and bonds made with other healthcare professionals and have expanded our reach worldwide.”


Over the past 70 years, MD Anderson has expanded regionally and partnered with hospitals all over the world, so the ability to have a global communications reach is crucial.



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The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare

In The Creative Destruction of Medicine, Topol argues that the digital revolution will fundamentally change the way medicine is practised. He proposes that the convergence of genomics (especially pharmacogenomics), with smartphones, biosensors, and other technologies will lead us to a near future where “medicine can and will be rebooted and reinvented one individual at a time”. At the heart of this vision is the need to move away from the current practice of treating people as populations to tailoring treatments to individuals.

Topol sees a future where genomics will help transform the way we test and administer drugs, individualising treatments on the basis of the specific characteristics of patients. It's a scenario, he points out, that seems increasingly likely given the declining cost of sequencing an individual's genome, which has dropped from about US$1 billion 10 years ago to less than $1000 today.


Topol discusses the potential of genome sequencing to advance individualised medicine by, for example, identifying those people at high risk of the most aggressive type of prostate cancer; targeting which patients really need statins and screening out those predisposed to rare but serious side-effects; and showing which patients cannot metabolise clopidogrel and convert it to an active drug. Topol suggests that such approaches would not only improve patient care but would also mean huge savings for the US health system.


He does caution that “Currently the ability to sequence is way out in front of our ability to interpret the data”, and admits that genomics has not yet delivered the goods with regard to identifying disease susceptibility. But if genomics does start delivering as Topol predicts, this could greatly accelerate the penetration of the digital genomics revolution into medicine, empowering individuals to contribute successfully to improving their own health care. In the meantime, Topol makes a convincing case that pharmacogenomics is delivering now, increasing our understanding of which genes are responsible for interacting with prescription medications.

Looking to the future, Topol presents another scenario in which nanotech sensors could identify signature cells in the bloodstream of patients whose arteries are on the brink of failing. The biosensors could wirelessly send a warning signal to the patient's phone, urging him to seek medical care before any physical symptoms of an impending heart attack, much like the “check engine” light on a car.

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Using Data Mining to Predict Epidemics Before They Spread

Using Data Mining to Predict Epidemics Before They Spread | healthcare technology |

In recent months, privacy has become the third rail of Internet politics. As companies capture more and more information about your activities online, what firms can do with that data and who they can share it with are becoming battlegrounds for rights activists, intellectual property holders, and others.


The healthcare industry isn't immune from the spread of Big Data, but it's also not necessarily something to be feared. Public health stands to gain a lot from understanding how we behave in the aggregate.


Consider the National Retail Data Monitor (NRDM), which keeps tabs on sales of over-the-counter healthcare items from 21,000 outlets across the United States. Knowing what remedies people are buying -- and how much -- is one way health officials are beginning to anticipate short-term trends in illness transmission.


Data from the NRDM show that sales of over-the-counter products like cough medicines and electrolytes actually spike before visits to the emergency room do. The lead time can be significant -- in the case of respiratory and gastrointestinal illnesses, it was about two and a half weeks, according to one paper. Another study examined pediatric patients at a Pittsburgh hospital and found that over 40 percent of parents had bought over-the-counter meds an average 1.88 days before bringing their children into the ER.


Being able to identify a possible disease outbreak probably won't do much to keep the pathogens from spreading, but it could help prepare first-responders and other health professionals. In 2010, it took weeks for official sources to report details of a cholera epidemic in Haiti that killed 7,000 and infected half a million others. But on Twitter, news of the disease traveled far more quickly, according to a study published in the American Journal of Tropical Medicine and Hygiene.


Breaches of privacy are serious, and should be treated that way. But not all data collection is invasive, or conducted online. Much of it can be good. The best might be saving lives.

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How to Improve EHR Performance With Clinical Best Practices | Healthcare Information Technology

According to an audit of electronic health record systems by Zynx Health in Los Angeles, a clinical decision support content provider, many U.S. hospital and health system EHRs barely earn a passing grade for implementing clinical best practices, especially when treating heart failure and pneumonia. The missing processes are standardized clinical best practices, which reduce mortality, readmissions and costs. EHR systems that have updated clinical processes may remind physicians and clinicians of important steps for improving a patient's care and recovery. Without them, the best possible outcomes may not be realized.


EHRs lack clinical best practices
According to Scott Weingarten, MD, CEO of Zynx Health, the audit was conducted to determine if hospitals and health systems were receiving the best benefits possible from their EHR systems. "Unfortunately, we found out they weren't," says Dr. Weingarten. The data to inform the audit was collected from 79 hospitals and health systems across the nation. The report focused on heart failure and pneumonia because of the high incidence of the diseases. They are also among the conditions CMS will no longer reimburse hospitals for when patients are readmitted within 30 days of a previous discharge.


"We did an exhaustive literature review of randomized clinical trials, meta-analyses, meta regressions, systematic reviews and practice guidelines," says Dr. Weingarten. "We found that almost all hospitals and health systems were missing many clinical processes. It showed us there is a real opportunity for the healthcare industry to improve." On average, hospitals had implemented only 67 percent of possible clinical processes within their EHR systems for pneumonia and only 62 percent of the clinical processes for heart failure. Additionally, the brand or EHR vendor did not make a difference. The missing practices were a result of the EHR user's implementation processes and the hospital's EHR optimization practice.



1. A sole focus on "going live." Since hospitals are implementing EHR systems to meet meaningful use and improve the delivery of healthcare services, they may place a large focus on quickly "going live." For this reason, many hospitals overlook important foundational elements. "Hospitals are focusing on going live quickly and for good reason. However, they go live and their governance processes may not ensure that they include all of the clinical processes that improve mortality, readmissions and costs," says Dr. Weingarten.


Dr. Weingarten compares the difficulty to cleaning out a garage. "Often, hospital executives intend to revisit the EHR system and add the clinical processes after the system "go live," but it does not always get done. Homeowner 'to do' lists are similar. When you first move into a home, you may keep the garage very clean. However, as time goes on the garage becomes cluttered. You keep saying you will clean it out on the weekend, but you do not get around to it even though you know you should. The same can be said of hospital EHR systems," says Dr. Weingarten. A major difference is that a cluttered garage does not jeopardize quality healthcare outcomes like absent clinical best practices could.


2. Physician culture. Physicians develop treatment habits and patterns, which can be hard to break. For this reason, physicians may find it hard to adopt new clinical processes, says Dr. Nolin. However, when there are constantly new best practices and treatment protocols, rigid habits and patterns can be disadvantageous. "Physicians like to keep habits because they support workflow and improve efficiency. As a result, [physicians] forget that they need to adhere to changes in best practices for better outcomes," says Dr. Nolin. "Sometimes physicians are expected to be all knowing. That mentality infuses the culture and is hard to change. Just because someone told a physician a method is better doesn't mean he or she will readily adopt the protocol. They need evidence to support that change," says Dr. Nolin.


3. Breadth of literature. If physicians and clinical staff could stay current with clinical best practices, the need for reminders and protocols built into an EHR system could lessen. Unfortunately, it is nearly impossible to keep up with medical literature because the volume is overwhelming, says Dr. Nolin. In order to identify all the clinical best practices, Dr. Weingarten and his colleagues combed through hundreds of journal articles, meta-analyses and studies. A physician or clinical staff member may not have the time or energy to do that work independently.


4. Focus of medical education. Best practices to reduce mortality, readmissions and costs are not widely incorporated into medical education. Dr. Weingarten remembers learning pathophysiology and the science of heart failure in medical school. However, he does not remember learning how to reduce readmissions safely. "When I was trained, cost was not a key part of the medical education and residency training," says Dr. Weingarten. "When I was in practice, I was probably not aware of all the ways to safely reduce costs."




Build clinical processes into EHR governance
According to Dr. Weingarten, one of the best solutions for all of the above causes is for hospitals to ensure that the appropriate clinical processes are built into an EHR through the system's governance process. This increases the likelihood the EHR will stay up-to-date. Hospital executives may assume that physicians will always solve the problem. "We have found that assumption to be wrong," says Dr. Weingarten. "Physicians are very intelligent. However, when they are engrossed in patient care they are not always thinking of including clinical processes to reduce mortality and reduce costs. There needs to be a method of governance to remind physicians and clinical staff what clinical processes to include.


EHR systems can be an effective means for coordinating and improving care. However, the benefit of an EHR system decreases if the critical clinical processes are not included. Due to physician culture, the breadth of medical literature and an emphasis on "going live" with EHR systems, clinical processes may be overlooked. In Zynx Health's audit, many hospitals and health systems received a grade equivalent of D for the inclusion of clinical best practices. To begin remedying the issue, hospitals and health systems should ensure that the governance of their EHR systems requires inclusion of best clinical practices.

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Marketing and social media: A success story

What the pharma industry can learn from In-Bed, Bayer Scherings award-winning online marketing campaign for Levitra.


Not too long ago, Dennis had a problem. To his great concern and that of his wife, Elaine, he suffered from erectile dysfunction (ED).


Today, however, after seeing a doctor and taking medication that addressed his symptoms, 40-something Dennis can now rise to the occasion. And hes even won a prize for it, too.


Dennis is not an actual person, but a cartoon character in the online marketing campaign In-Bed (, for Bayer Scherings erectile dysfunction drug Levitra.


Produced by British advertising agency Profero, the educational campaign has not only appealed to Internet users but also achieved what few in the industry ever deemed possible: In-Bed won the much-coveted Grand Prix awarded by Revolution magazine for outstanding digital marketing.


Due to the many legal regulations governing DTC advertising by pharma companies outside the US, ads often lack creativity. Not In-Bed, though.


According to the Revolution jury, The fact that Bayer Schering overcame these obstacles helped this campaign stand out from all others. And the fact that it took a unique and innovative approach to ED clinched the verdict.

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US doctors' use of iPads and smartphones 'evolving rapidly'

Doctors’ use of mobile devices like smartphones and Apple’s iPad is firmly in the mainstream, according to new US figures.


Adoption of tablet devices by US physicians, for whom the iPad is the dominant platform, has nearly doubled since 2011, with 62 per cent of those surveyed saying they use one for professional purposes.


Half of those doctors who own a tablet have used their device at the point-of-care, Manhattan Research said.


“Physicians are evolving in ways we expected – only faster,” said Monique Levy, vice president of research at Manhattan Research. “The skyrocketing adoption rates of tablets alone, especially iPads, means healthcare stakeholders should revisit many of their assumptions about reaching and engaging with this audience.”


This probably puts US doctors ahead of their European counterparts when it comes to use of tablet devices. A similar study from Manhattan Research earlier this year found that 26 per cent of European doctors own an iPad.


Meanwhile, the use of smartphones is even more widespread in the US, with the research finding 85 per cent of US physicians own or use a smartphone for professional purposes.


Other figures released this week from a US online doctors-only community also highlighted physicians' use of smartphones. Championing the app it launched 10 months ago Sermo said nearly half (45 per cent) of its total website traffic comes from the Sermo Mobile app.

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‘Smart Health – Better lives’: How European countries reap the benefits of eHealth

Bjørn Astad, Head of Division in the Norwegian Health Department presented the Norwegian eHealth strategy this morning in a session aimed at Sharing Knowledge and practice on interesting eHealth projects in Europe.


Astad said that the country´s healthcare reform was in fact a “coordination reform” with clearly defined goals: first, to coordinate activities and information sharing among healthcare providers; second to enable primary care to provide more services; and third, to reduce the need for expensive specialized care.


ICT critical for healthcare reform


Astad underlined, that the Norwegian government has positioned ICT to be “one of the most important tools to improve healthcare and reach the goals of the reform.” And the country has come a long way in implementing the reform.


Today, the “eHealth highway” is the Norwegian health net: a secure national data network connects 3,100 healthcare providers including all hospitals, all GPs, and 80% of the municipalities. Participation in the network is mandatory to be able to send electronic messages to other healthcare providers.
A year ago the country launched In its first stage, it is purely a citizens´information portal. In future, it will provide services to patients and give access to health data.

Electronic prescriptions are well advanced. Norway started the rollout in 2009, and by end of 2013, all of Norway will be on electronic prescriptions. “This is a way to raise patient safety and reduce the number of medication errors”, Astad said.

The Electronic Patient Summary will start piloting in 2013, with the rollout scheduled for 2014. Norway has changed legislation to support a central archive with patient data that can be accessed by health personnel with the consent of the patient. Citizens may opt out of the archive.

Electronic messages provide a standard information exchange of referrals, prescriptions, test orders and result.


Astad observed that top-level political support is key to implementing a national strategy, in order to give the project legitimacy, but also to create an adequate legal frame-work to support the eHealth rollout. He also emphasized that the action plan must meet concrete needs and support their realization, and he recommends the engagement and integration of all stakeholders in the plan. Last, but not least, data protection and security must meet high standards in order to get buy-in from public and healthcare providers


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The Patient, the Physician, and Dr. Google

In July of 2002, I watched as my wife, a practicing obstetrician/gynecologist, was deluged with telephone calls as scores of her patients began processing the news that the National Heart, Lung, and Blood Institute had halted the combined estrogen and progestin arm of the massive Women’s Health Initiative clinical trial because of concerns of risk over invasive breast cancer.


What was perplexing about the experience, I recall, was that many of the women calling had already downloaded a preprint of a JAMA article explaining the institute’s decision a full week before the print issue had arrived at my wife’s desk. Naturally, the callers were filled with questions. One of my wife’s more innovative solutions was to invite interested patients to a journal club review of the online article, so that they could go over and digest the new information together.


What I was watching firsthand was playing out in physicians’ offices around the country. In 1999, a study of online information revealed that health-related concerns dominated much of what people were looking for on the newly opened “information superhighway” . Patients were doing an end run around traditional medical sources and were beginning to search online for answers to their health-related questions. What they found, though, was a hodgepodge of medical information, from cutting-edge study data to dubious advertisements for miracle cures .


Often it was difficult to tell what the source of information on a web site might be, and many ostensibly credible web pages were actually masking a spate of ulterior motives. Direct-to-consumer advertisers were especially prevalent in this space, with new online companies making it easy to skirt local jurisdictional restrictions on the sales of pharmaceuticals. Phishing (i.e., the fraudulent practice of sending people to a bogus web site that collects their personal account information) and “pharming” (i.e., the tactic of enticing consumers to download malevolent software in the guise of updating antivirus software) added to the lack of trustworthiness .

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Society: Give patients 'immediate' access to EHR data

Society: Give patients 'immediate' access to EHR data | healthcare technology |
The Society for Participatory Medicine (SPM) has expressed concern that proposed delays in allowing patients access to their EHR records under Stage 2 of the Meaningful Use EHR incentive program are "arbitrary" and will hurt patient care.

In a comment letter submitted to CMS May 4, the SPM warned that the proposed four-day grace period between the time that eligible professionals obtain patient records and when they must provide access to the patient impedes the continuity of care--as does the proposal to give providers 36 hours to provide discharge information after a patient leaves the hospital.


"Information should be available to the patient and patients' designees as soon as it is available to any clinical user of the [certificated EHR technology] other than the author of the information itself," SPM said in its letter.

Using the mantra "nothing about me without me," the SPM also recommended, among other things, that the rule allow for some automation for the accessing and downloading data to increase the likelihood that patients will access their electronic records.

In contrast, The American Hospital Association requested in its comment letter that the 36 hour delay wasn't long enough; it asked CMS to give hospitals 30 days after a patient's discharge before having to provide discharge information to patients.


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How the medical industry is using (and could use): Pinterest

How the medical industry is using (and could use): Pinterest | healthcare technology |
The medical industry has developed a certain comfort level with the first generation of social media sites: Facebook, YouTube, Twitter and LinkedIn. A second wave – including Pinterest, Google+ and StumbleUpon – offers hospitals, medical device and pharmaceutical companies a new set of tools for building a social media strategy.


The picture-driven Pinterest made Internet history recently by rocketing to 10 million subscribers in just under two years, and has already surpassed all of the original four except for Twitter for referral traffic. The majority of users are early adopters of social media, women in their 20s and 30s who are sharing pictures in categories ranging from beauty and fitness to science and nature.


“[Pinterest] is fascinating,” said Brendan Gallagher of Digitas Health. “It’s social commerce cleverly disguised as an aspirational visual scrapbook,” referring to Pinterest’s deal with Skimlinks to generate revenue.

Users can upload images directly to a particular “board” or use a toolbar widget to “pin” an image from a blog post or web page. The software automatically imbeds a link in the image, making it easy to find that recipe, pair of shoes, or infographic again. Although there is a considerable retail component to Pinterest through links, there could be room for much more than that. Users can follow a board, repin images to their own collections and like individual pins. 

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A new vision of healthcare for Europe

A new vision of healthcare for Europe | healthcare technology |

Europe is known the world over for its universal public healthcare systems. But these systemsare at risk of becoming financially unviable and suffering from a lack of human resources to deliver the required care.


In the face of demographic change and financial austerity, we must rethink the way we deliver, organise and finance healthcare. Fundamental reform of our systems are needed, enabled by information and communication technologies (ICTs).

I do not mean big projects like the National Programme for IT, which have come to dominate the perception of ICT in healthcare. I mean new approaches for telemonitoring, electronic prescriptions, and applications that help prevent people from needing acute care and allow the elderly to live independently in their homes.


Many of these have been tested in the UK under the Whole Systems Demonstrator project and have demonstrated huge benefits for patients, medical specialists, and care workers and have considerably reduced health care costs and boosted productivity.

Why? Because this is not actually about the technology. I would love to make healthcare less intrusive and more personalised, as well as more affordable.


The way to do that is to design care around patients, and the means of achieving that is better integrating digital technology into caring processes. That is worth fighting for, even if there are stumbles along the way.


At the centre of this vision is the power of data. By unlocking and liberating this data we can truly revolutionise health.

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Majority Of Doctors Will Use iPads On The Job By 2013

Majority Of Doctors Will Use iPads On The Job By 2013 | healthcare technology |

The iPad’s design and capabilities have always made it intriguing option for doctors and other healthcare providers. Shortly after Apple launched the iPad two years ago, technophile doctors began bringing them into their offices and a number of hospitals began launching pilot programs centered around it.


That initial burst of interest and enthusiasm hasn’t slowed in the slightest according to a new report from Manhattan Research. In fact, iPad use by U.S. doctors has nearly doubled in the past year and adoption is set to continue at a meteoric rate over the next twelve months.


The report noted that physician iPad adoption has soared and that 62% of U.S. doctors reporting using one for professional purposes. Half of iPad-owning doctors also reported using their device at the point of care (exam room, hospital, and so forth).


The iPad’s design offers a lot of promise and problem solving in point of care use. It offers the benefits of electronic medical records in a form that’s similar to a paper chart and that doesn’t create a barrier between doctor and patient – a common complaint about laptops used for similar purposes. It also offers doctors the ability quickly (and somewhat more accurately) illustrate injuries, conditions, and treatment options to patients.


Outside point of care use, the iPad (and the iPhone) offer instant access to all kinds of medical references.


“Physicians are evolving in ways we expected – only faster,” noted Monique Levy, vice president of research for Manhattan Research.


Going forward, the research firm expects to see even greater adoption and is predicting that two third’s of U.S. physicians will be using iPad’s professional by 2013. That puts them a bit ahead of the curve compared to doctors in Europe, where a similar study showed 26% of doctors owed iPads and used them professionally.


Beyond the iPad, the study also showed that 85% of doctors use a smartphone professionally and that two thirds of doctors are now using online video sources to expand and update their skills.

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Exploring the Role of Mobile Technology as a Health Care Helper

Exploring the Role of Mobile Technology as a Health Care Helper | healthcare technology |

Mobile technology is changing the landscape of health care delivery across the developing world by giving people who live in rural villages the ability to connect with doctors, nurses and other health care workers in major cities.


“Now, a phone call can compress the time that it would have taken before to come to that decision point and get the woman care more often and quickly,” said Dr. Alain Labrique, a professor of International Health and Epidemiology at Johns Hopkins University, in Baltimore.


More than 60 faculty members and 120 students are part of the Johns Hopkins Global mHealth Initiative, which has 51 projects exploring the use of mobile technology in health.


Its work received such a positive response that in March 2013, the Johns Hopkins Bloomberg School of Public Health will begin two courses on incorporating mobile technologies into global health fieldwork.


“The students coming into global health today are challenged with the need to think of the potential appropriate use of these technologies in the resource-limited areas where we work,” said Dr. Labrique. “There’s a lot of excitement among faculty, but there’s 10 times as much excitement coming from students.”


“What mobile technologies are doing is changing the way that we see global health in terms of our ability to impact populations, to collect data in real time, to develop real strategies to impact public health that we hadn’t thought of before,” he added.


Dr. Larry Chang, a Johns Hopkins researcher who studied H.I.V./AIDS and the use of technology in Uganda, said that “over the past decade of working in Africa you really started seeing this amazing growth in the use of mobile phones and it seemed obvious to use it for global health.”


While mobile technology is one of the quickest ways to deliver health care to those who would otherwise have little to no access, there are challenges in making the technology effective.


“There hasn’t been a lot of rigorous evaluation of their impact,” said Dr. Chang. “We need to study and make sure that these devices are doing what people say they are doing and that they are really helping people.”

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6 ways to develop a nursing blog

6 ways to develop a nursing blog | healthcare technology |

Patient satisfaction is linked to nursing. Give nurses a social media voice.


Nurse blogs can be key influencers for your hospital


So, why not harness these key influencers for your hospital? An article by Joni Watson in this month's Clinical Journal of Oncology Nursing addressed just this.


In her article, "The Rise of Blogs in Nursing Practice," Watson wrote, "Patients increasingly are turning to the Internet for personalized, timely, and relevant health information; blogs remain a large source of that information. Nurses and other health care professionals can harness the informational, educational, networking, and supportive power of blogs, as well, and should understand how to access and use blogs for professional use."


The media landscape is right for hospital blogs. I agree with Watson regarding the value of offering a blog written by nurses and the opportunities for both the patients, the community and hospitals.


6 points to consider as you develop a blog


Let's dive into it:


Have a social media policy and provide mandatory social media training that specifically addresses HIPAA issues encountered online so the nurses will be prepared and the hospital will avoid violations.


Recruit nurses who are well liked and have an interest in blogging. Their willing attitude will come across online.


Designate specific times for the nurses to blog as part of their schedules. Don't expect them to add it to their already full schedules without compensation.


Consider a name for your program that enhances the message of care that your nurses bring.


Once the program is established and is running smoothly, promote the blog with patients, families, on the hospital website, with doctors and in the media. Even a wearable button made for the blogging nurses can help spark awareness among patients and family members about the blog.


Do allow filtered comments. Interaction through comments enhances patient engagement and loyalty.

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E-Prescribing Adoption: A Prescription for Progress

E-Prescribing Adoption: A Prescription for Progress | healthcare technology |
Think about the last time you were prescribed a medication. Did your doctor fill out a prescription on a paper pad and instruct you to get the medication filled at your local pharmacy? If not, chances are that he or she electronically routed the prescription to your pharmacy. This process—called electronic prescribing or “e-prescribing”—is helping prescribers and pharmacists make better clinical decisions, improve workflow, reduce costs, and ultimately enhance patient care.


E-prescribing Adoption: Where We Are Today

The nation has witnessed a significant increase in e-prescribing adoption over the last several years. Surescripts, which operates the largest electronic prescribing network in the country, shows data from February 2012 that indicate approximately 401,000 prescribers are on its network. This is an increase in e-prescribing adoption of more than 400 percent since December 2008. Additionally, more than 92 percent of retail pharmacies are actively e-prescribing, representing a 20 percent point increase from December 2008

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Achieving Patient Safety with EMR

Achieving Patient Safety with EMR | healthcare technology |

clinicians have relevant information in front of them when required, in the right way. This means instantaneous access to the information that is relevant to the services they are providing at that particular time, in a format that is customized for utmost usability, while ensuring the integrity and confidentiality of such information.


A recent survey cited poor communication, such as exchanging important clinical information about patients as the largest barrier to achieving patient safety goals. And despite the fact that EMRs are an effective tool to improve the exchange of clinical data and, in turn, quality, healthcare professionals are not exactly raving about the effects the EMR system has had and how much they can help.


Let’s take a moment to soak in just how bad the communication is.According to the aforementioned survey, several respondents were asked how often important patient care information is lost during shift changes. A massive 56% answered always; often 12%. Only 27% said it rarely happens while a mere 5% said it never happens.


EMRs provide a simple solution to such problems, since electronic data doesn’t hitch a ride home in the back of a nurse’s mind at the end of his or her shift. Electronic data does not get lost when it’s mixed in with the take-out menu pile and it doesn’t get ruined when someone spills coffee on it. In short, electronic data doesn’t fall through the cracks unless you willfully refuse to look at and use it.


This does not rule out the impact of human interaction and communication. Healthcare is after all, a very human-centric business. It is pertinent to note that many safety issues could be avoided or minimized with an extra minute or so of one-on-one communication. However, communication issues still pose a fundamental challenge for healthcare. Thousands of individuals are involved in patient care. Ensuring that they communicate all the key clinical findings during handoffs – shift to shift, in-patient to radiology for a test, or floor to floor, to the lab and back – is a challenge.


The challenge that many systems are facing is the inconsistency in the choice of an EMR system between providers. Data sharing between different EMR systems is often limited and merely available in a read-only format. Whereas, if a single EMR system (database) is used by a multitude of providers, such limitations can be overcome. Consistent backing of EMR adoption by the U.S government aims to propel healthcare information exchange into a new era. The introduction of Health Information Exchange (HIE) aims to enable clinical data sharing across different EMR platforms throughout the nation.


Overall, EMRs can significantly improve communication along with the quality of care delivery. EMR vendors continue to strive towards developing a system which provides comprehensive safeguards for the protection of patient information. This is already a priority for healthcare professionals in the industry, but it is also important for patients themselves to work together with their clinicians to get these systems to the level they need to achieve: safe, accurate, and easy to use.


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Healthcare Companies Still Don't "Get" Social Media

Healthcare Companies Still Don't "Get" Social Media | healthcare technology |
“Social media is changing the nature of healthcare interaction, and health organizations that ignore this virtual environment may be missing opportunities to engage consumers.”


That was the very ominous and foreboding opening line from a press release announcing the findings of a report done by the Health Research Institute (HRI) at PwC US.


Anytime I see the words “engage” and “missing” I am automatically intrigued because as we all know it’s all about engagement: how to get engaged with your customers, how to stay engaged with your customers and how to ensure they stay engaged with you.


The report compared the social media activity of hospitals, pharma companies and health insurers to that of community sites and as you can see there is no comparison as community sites had 24 times more social media activity than corporate sites.


This is very significant as the report aptly points out in that it has serious implications for “businesses looking to capitalize on social media opportunities.”


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The Big Payoff From Wellness and Prevention

The belief that “an ounce of prevention is worth a pound of cure” is so well ingrained that it makes it easy to think we can solve our health care cost crisis the easy way, by increasing spending in one area to bring down costs in another. It doesn’t necessarily work that way, at least in the short term, which is why prevention isn’t a surefire bet to keep down health insurance premiums.


But an article in today’s New York Times (Working Late, by Choice or Not) indirectly points to the big benefit of wellness and prevention, which is the ability to remain in the workforce into old age, rather than having to retire or slow down substantially based on chronic disease or disability.


Millions of baby boomers are now reaching the traditional retirement age of 65, but it’s in their interest and the interest of the country as a whole that many of them continue working for a long while after that.


The big financial payoffs come from enhanced productivity, which increase the size of the economy, increased tax revenues to help cover the deficit, and an ability to counteract shortages in the labor force caused by reductions in immigration, policy changes, or poor planning.


While I’m sure older people aren’t happy about it, the fact that fewer retirees have employer paid pensions or health insurance, and that the Social Security eligibility age is rising a bit, increase the level of interest for older people to stay in the workforce.

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Technology is moving on but don’t assume the Doctors using it are…

Technology is moving on but don’t assume the Doctors using it are… | healthcare technology |

“Virtual” Consulting


It’s unsurprising that people who have never done a remote video consultation with a Doctor refer to it as a “virtual” experience. But there is NOTHING virtual about a registered Doctor consulting with you about your health over video especially if they have your full history.


Arguing it is ‘virtual’ is to my mind like claiming I virtually flew to the Middle East last last week because I arranged it all online.


“Morning! morning Doctor how are you today? Good, can you tell me your name please?”


These opening lines of the video suggest to me this Doctor has very little experience of effective remote consulting.


I’m quite confident of this as in 6 years of offering 3G Doctor we’ve never had to ask a patient to tell us their name. Why? Because it’s not an effective way to ensure the identity of your patient (you should at least be referring to a stored facial image in their EMR), there are better ways (like discussing the details in the history they’ve shared before the consultation), it’s a waste of time that’s akin to the lack of purpose and pointlessness you pick up from video call demos in which participants wave to one another due to their discomfort and lack of focus.


“Telemedicine is a fairly new medium”


Really? Ever consider the work of the Royal Flying Doctors? Ever wonder how the Navy, oil rig workers or Astronauts access care?


“I don’t think it will replace traditional medicine. It will just be an adjunct for patients who have simple issues or who are between Doctors or need a refill”

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Experts: Use patients to reduce errors in electronic records

Giving patients better access to their electronic health records is not only part of Stage 2 of Meaningful Use. It's also an effective way to improve the quality of the data, according to a panel of experts who spoke on a recent webinar hosted by the National e-health Collaborative, a public-private partnership established by a grant from the Office of the National Coordinator for Health IT (ONC) to foster national health information exchange (HIE).

"You can't proofread your own stuff. You have to have a second pair of eyes," said speaker Dave deBronkart, co-chair of the Society for Participatory Medicine.


DeBronkart pointed out that patients often catch mistakes in their medical records. He likened bad data to an infectious disease, which spreads like "crazy" if not fixed.

However, more research is needed to determine the best way to provide patients with access to their electronic records, said Prashila Dullabh, Health IT program area director of NORC, a research organizatrion affiliated with the University of Chicago. "There is great variety in how EHRs handle amendments," she said.

One promising way to share data with patients and correct mistakes is to use patient portals tethered to EHRs, Norman Sondeimer, Ph.D., co-director of the electronic enterprise institute at the University of Massachusetts, Amherst said during the webinar. A recent study of eight hospitals' patient portals found that the portals can encourage feedback using a feedback button embedded on the screen. Then an icon can identify that the patient suggested an edit to the data, giving the provider the opportunity to review and formally change the medical record.


While the concept of providing patients access to their digital data didn't appear controversial, there are concerns that requiring it of all hospitals to meet Stage 2 of Meaningful Use may not be practicable. The American Hospital Association (AHA) noted in its comment letter on the proposed rule for Stage 2 that the requirement raises security issues and that many hospitals do not yet have the technical capability.

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Cloud Computing Won’t Be the Death of Client Server EMR – Something Else Will Be

One of the all time favorite topics of discussion here at EMR and HIPAA is around SaaS EHR software versus client server EHR software. They each go by many other names and the technical among us might know the hard core technical difference between each, but most doctors don’t know and don’t care.


SaaS EHR software is often called hosted EHR software or ASP EHR software or even Cloud Computing if you want to use a general term. Client Server EHR software is sometimes called in house EHR software or self hosted EHR software. I’m sure there are other names I missed.


Regardless of what you call it, many people (usually those from SaaS software vendors) believe that client server software will lose out to the cloud. It’s hard to argue with them since in almost every other industry cloud based software has won.


Here’s why I don’t think we’re going to spell the death of client server software for a long time to come. Client server is going to be here for a long time because of such wide adoption by so many doctors.


Not to mention, many of the client server EHR systems are really large implementations that would be hard to displace. Plus, there are many doctors who don’t care about the mobile benefits of a SaaS based EHR software. Quite a few doctors want to only use their EHR software in their office.


Certainly there are others on a client server based EHR system which will want to access their EHR outside of their office. Unfortunately, instead of EHR replacement we’re likely to see a hybrid environment that supports client server and some sort of app environment come out of the various client server EHR vendors.


Sure, a lot of doctors will also use Citrix or other remote desktop environments and hate the user experience, but it will pacify them until the hybrid EHR environment is built. In fact, that hate towards the remote desktop environment on a mobile device will drive the development of this hybrid approach. The advantages of a client server environment with an app connection will keep the client server environment around for a while.


So, while many want to declare the death to client server, I’m not ready to do so. Sure, SaaS EHR software has its advantages, but client server software isn’t going to go down without a fight and they’re going to be around for a while since in many cases they hold the high ground.

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The Growing Power of Social Media in Healthcare

The Growing Power of Social Media in Healthcare | healthcare technology |

I remember the first time Twitter had an actual impact on my life, rather than just acting as a meaningless platform for me to vent and comment. Ironically, it was during one of my venting sessions.


After moving to a new apartment, I was having trouble understanding why there was money owed on the cable bill from my previous apartment. I complained about my previous cable provider for making my life needlessly difficult in an innocuous tweet. Shortly thereafter a representative from the company contacted me and offered to help clear up my conundrum, which he ultimately did.


This kind of customer service floored me. I didn’t expect it at all.


Going the extra step and appealing to consumers, while tapping into their concerns in this way, is the kind of phenomenon that’s starting to occur in healthcare, and one hopes will become even more frequent as providers and payers implement social media business strategies.


In a recent conversation I had with John Edwards, director of the healthcare strategy and business intelligence practice at PricewaterhouseCoopers (PwC), he talked about how social media can improve patient experiences and drive engagement for providers, payers, and pharmaceutical companies.

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EU e-Privacy: Can Cookies be bad for health?

EU e-Privacy: Can Cookies be bad for health? | healthcare technology |

For quite a long time, the majority of people have used websites blissfully unaware of the level to which their online habits could be used to develop a profile by advertisers, companies and governments; information which might be the basis of targeting with customised messages or observation.


No pun intended, but ‘Target’ (a discount store chain) recently made waves in the media when it became clear that their ability to mine customer information from multiple channels had helped them to identify that a father’s daughter was pregnant before he himself knew about it.


While this instance was not necessarily about online shopping, the concept of gleaning customer relationship management data is familiar – even more so when using website technology. This may not particularly bother someone who is using Amazon to buy some books, however when it comes to health information, many people consider this to be one of the most important, personal and sensitive areas of our lives. Individuals will often choose carefully how and when they reveal detail about conditions or illnesses that they may be experiencing.


The idea that a company might send an email to congratulate you on your pregnancy – even potentially before you yourself became aware of it – is either disturbing, or exciting, depending on your attitude to technology and privacy.


Cookies and multi-channel marketing


Pharmaceutical companies are, like most digitally-enabled information providers, increasingly looking to integrate touch-points and measurement across multiple channels and campaigns. One way of achieving this is through the use of tracking cookies. It is not always an easy thing to do in practice, yet even when successful in an approach for implementation, a brand can then still face new hurdles around a person’s individual privacy preference.


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