With their countless applications, electronic textiles are making lives better on so many levels – health and safety is just two of them.
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Five years ago, the Nintendo Wii was touted as the new "it" thing for improving seniors' health--bowling leagues sprang up in nursing homes, and physical therapists "prescribed" Wii yoga programs to their older patients.
A third of U.S. consumers now use social media sites such as Facebook and Twitter to seek medical information and track and share symptoms. They're also using the sites to vent about doctors, drugs, treatments, medical devices and health plans.
The survey of 1,040 U.S. consumers was put together by consulting firm PricewaterhouseCoopers (PwC) and includes data from a separate survey of healthcare and pharmaceutical executives on how social media is used in their business strategies.
Not unexpectedly, young adults rely on social networks for healthcare information far more than older Americans.
The survey found that more than 80% of those between the ages of 18 and 24 said they're likely to share health information through social media channels -- and nearly 90% said they would trust information found there.
By comparison, less than half (45%) of those surveyed between the ages of 45 and 64 said they're likely to share health information via social media.
This month, nine major medical specialty groups published a list of 45 tests and procedures that often have no clear benefit for patients and can cause harm — CT scans for simple headaches, for example, and X-rays for routine lower back pain. You don’t often hear calls from doctors for fewer tests and procedures.
And that’s too bad. Many of them have been oversold, their benefits exaggerated and their harms ignored.
Discussions about the potential impact of mobile health technology often center on patients' general reluctance to share personal health information (PHI), whether it's with physicians or applications such as personal health record (PHR) services.
John de Souza, CEO of the online health community MedHelp, disagrees.
In 2008, MedHelp saw "tens of thousands" of posts from women who got rashes and welts after wearing certain Victoria's Secret bras, de Souza said during a panel discussion at last month's Institute for Health Technology Transformation's iHT2 Health IT Summit. That all-too-personal data was powerful, too, as it helped Victoria's Secret trace the problem to a formaldehyde spill at a single factory in China.
Usability, not privacy, hindering mobile health technology adoption
The incident demonstrated that users are more than willing to share PHI if they think doing so, even in a roundabout way, may make them healthier, de Souza said. This is becoming increasingly true as telehealth and mobile health technology becomes more omnipresent.
For many health organizations, the biomedical engineering and IT teams do not both directly report to the CIO. While in the past that would be somewhat acceptable, nowadays biomed engineers can significantly benefit from working more closely with the IT department, which has encouraged many hospital and health system CIOs to begin looking for ways to combine IT and biomed together under the management umbrella.
In many of the top wired hospitals in the nation today, the integration of medical devices and connectivity of systems is key to their success. This only highlights the importance of IT and bioengineering working together to ensure that all medical device vendors are providing systems that can play nice in this new ecosystem where devices are expected to push / pull data sets and eliminate manual data entry when it comes to patient data.
Without a doubt, IT is a core component in the evolution of patient-centered care. Nonetheless, finding the right balance between patient engagement and new IT initiatives can be challenging.
"Focusing specifically on the physician-patient relationship – it's behind the rest of the world," said Steve Wigginton, CEO of Medley Health, a medical practice marketing and communication services company. "But there are a lot of benefits to be had. More information is readily available to physicians as a result of IT, and therefore, it's easier for them to keep track of what's going on with their patients."
"IT has, in some ways, made it possible for patients to be more self-serviced around transactional types of interchanges with their doctor," Wigginton continued.
This includes scheduling appointments, reviewing bills, etc. “Those are just some of the main ways we're seeing IT have an impact so far," he added.
One of the areas that has seen changes in the NPRM for meaningful use stage 2 includes the standards according to which health data is exchanged. In this case, the affected areas are related to clinical messaging, electronic prescribing, and patient summary and transport specifications.
Specifically, one of the standards has been substituted for another. In meaningful use stage 1, the selected standard was CCD/CCR (HITSP C32); however, in the new ruling this was replaced with consolidated CDA. The original standards (C32) included administrative and clinical information — registration, demographics, insurance, problem list, medication list, allergies, test results, etc.
One of the reasons the consolidated CDA was selected as the standard is due to its single implementation guide, as well as the centralization of many of its templates. These templates allow for more information to be exchanged amongst different clinical applications and systems.
Almost every physician who has typed orders into an electronic health record or e-prescribing system probably has experienced so-called alert fatigue — the frustration of warning after warning popping up before that order is accepted. The alerts are designed to inform physicians of possible patient safety issues, but their frequency and often lack of necessity make them the electronic equivalent of the boy who cried wolf.
As researchers and health care organizations work to alleviate alert fatigue, it’s clear that the answer is to create systems that take human behavior and supplemental patient data into account when writing rules that decide when and why an alert is fired off. That way, the alerts could have more success in their purpose: protecting patient safety.
“The issue of alert fatigue is that we are not just sending alerts that are considered to be irrelevant, but when you get enough of those, even the alerts that are important are disregarded,” said Jon D. Duke, MD, assistant professor at the Indiana University School of Medicine. Several studies have found the ignore rate for alerts averages between 80% and 90%.
On the HIMSS site, we’ve made the white paper, and both the provider and consumer pieces (excerpts from the white paper), freely available to HIMSS members and non-members alike.
In the white paper, we identified a variety of uses by providers, such as:
Informational and educational purposes for both internal and external audiences (the latter of which can also produce a positive return on investment through patient acquisition or increased patient loyalty);
Determine your goals for participating in social media channels.
Games could be the most important digital health tool of the 21st century and have a highly influential impact on the engagement pharmaceutical companies foster with health care professionals, patients and the public. Yet it is tempting for people to separate them from the ‘serious’ business of work, education and health.
As well as being at the forefront of the entertainment industry, games are a rewarding form of personal expression and communication for millions of people around the world. Games also represent the most powerful ingredient in the human interaction with technology; fuelling development of the interface tools people take for granted in their relationships with computers and driving technical development.
So what defines a ‘game’? Jane McGonigal, director of Games Research and Development at The Institute for the Future, Palo Alto, California, believes that games share four key defining traits:
The goal is the specific outcome that players work to achieve. This focuses attention and guides progress. It provides the sense of purpose.
There has recently been a debate going on regarding whether advances in mobile health are helping or hurting patients. I read an article, How iPads Improve the Patient Experience, which gave one side of the story on how mobile technology can be a boon to treating patients.
The iPad has also been helpful in making hospital check-in quick and paperless, as well as helping doctors communicate with remote patients.
A patient enters the waiting room and is greeted warmly by her personal navigator, who hands her a tablet-sized computer preloaded with her personal demographic information and health records. She answers a series of questions and the computer compiles a list of possible diagnoses for her physician.
In his office, the physician is reading an e-mail from a patient who has forwarded an interesting study about his particular medical condition. The physician forwards the study to the rest of the patient's care team, including the patient's acupuncturist.
In the exam room, a specialist and patient sit together in front of a computer—the physician is showing the patient which sites have the most reliable medical information that she can use to learn more about her recent diagnosis. Next door, a physician is talking to a patient who has unusual symptoms; the doctor consults her PDA, which is loaded with a decision-support application.
Down the hall, an employee e-mails to a prospective patient a detailed, itemized list comparing the costs of hip replacement surgery at a number of area hospitals.
And, by the way, everyone in the waiting room is fit and trim. Nobody smokes anymore. People with diabetes check their blood sugar regularly. Everyone shows up for their colonoscopy appointments. People are knowledgeable about their health, empowered to participate as partners in their care, and engaged enough to comply with their physicians' directives.
The west Orange County nursing home is using Apple iPad 2 tablets to jump-start residents' memory, mobility and social skills that have deteriorated through age, Alzheimer's disease or other types of dementia.
"It came to us as a happy accident," said Judy Skilton, Health Central Park's director. "What started out as one resident's curiosity about … an iPhone turned into something that is helping them spell, track items, make choices and read words. It's amazing."
The iPad's innovative approach with the elderly could open doors to new geriatric and Alzheimer's research as the nation's baby boomers near retirement age and tablets increase in popularity, experts say.
"They are on the cutting edge of technology and geriatric care," said LuMarie Polivka-West, president of Florida Health Care Association, the state's largest advocacy organization for long-term-care providers and the elderly. "We hope to encourage the use of this new technology."
Smartphone apps motivated more than two-thirds of participants in a Stanford University study to exercise more, sit less and improve their diet.
The convergence of these two fields—genomics, marked by the rapidly plummeting cost of sequencing a person's entire genetic code, and wireless, with its flurry of innovative health-care apps—led Dr. Topol to write "The Creative Destruction of Medicine," a book that offers an illuminating perspective on the coming digitization of health care. It's also a reminder that while medicine is one of the globe's premier drivers of innovation, it is also a conservative culture that now finds itself buffeted by transformational change.
The Wall Street Journal's Ron Winslow discussed the implications with Dr. Topol. Here are edited excerpts from the conversation:
Social media is changing the nature of healthcare interaction, and health organizations that ignore this virtual environment may be missing opportunities to engage consumers, according to a new report by the Health Research Institute (HRI) at PwC US entitled, “Social media likes healthcare: From marketing to social business.”
The report found that social media activity by hospitals, health insurers and pharmaceutical companies is miniscule compared to the activity on community sites. While eight in 10 healthcare companies (as tracked by HRI during a sample one-week period) had a presence on various social media sites, community sites had 24 times more social media activity than corporate sites. The finding holds significant implications for businesses looking to capitalize on social media opportunities.
“The power of social media for health organizations is in listening and engaging with consumers on their terms. Social media has created a new customer service access point where consumers expect an immediate response,” said Kelly Barnes, US Health Industries leader, PwC. “Health organizations have an opportunity to use social media as a way to better listen, participate in discussions and engage with consumers in ways that extend their interaction beyond a clinical encounter. Savvy adopters are viewing social media as a business strategy, not just a marketing tool.”
As we look at the causes driving EHR adoption, there are many that immediately come to mind. Providers are looking to improve care and patient safety, as well as get their piece of the EHR incentive program pie. There is also the movement toward paying for performance (P4P), reducing waste by eliminating paper records, and supporting access to health information from anywhere, at anytime.
But for many physician groups, there is a significant impact on the organization from the practice management system standpoint that cannot be ignored.
There are many strong motives that drive the decision to replace a practice management system
This artice discusses these motives
There are many initiatiaves that large health system can begin employing now to ensure the revenues are not threatened by the changing health care payment landscape. Many are predicting that health care is moving toward a system where providers will be rewarded based on outcomes, with compensation being mainly based on quality measures. This is no different than the framework used by participants of the ACO pilot program, which provides these groups with bundled payment for an entire episode of patient care. This encourages physicians to keep patients healthy, and out of the their practice / hosptial.
This would mean that while the current model rewards hospitals for the number of patients admitted along with the number of procedures performed, the new direction will aim to keep a subset of patients at bay by ensuring that they are leading a healthier lifestyle with less hospitalizations. This will significantly impact the bottom line at health organizations that are unwilling to change and adjust to the changing landscape.
"Since its introduction in the 1970s, telemedicine – the electronic linkage of healthcare providers and recipients – has held promise for improved disaster response outcomes," said the study's senior author, Nathaniel Hupert, associate professor of public health and medicine at Weill Cornell Medical College and co-director of the Cornell Institute for Disease and Disaster Preparedness. "As information technology becomes pervasive, we want to ensure that systems are in place to fully realize its potential for helping patients – particularly for emergency response."
The team's results, published in the Journal of Medical Systems, show that introducing telemedicine linkages between remote specialists and immediate responders in the aftermath of a widespread disaster such as an earthquake could decrease both patient waiting times and hospitalization rates at nearby hospitals, while increasing the likelihood that patients with life-threatening injuries receive appropriate care – as compared with standard emergency department-based triage and treatment.
"In this time of national crisis, it would have certainly been helpful for Japan to have a robust healthcare IT network in place," wrote Nrip Nihalani on his blog Wirelysis. Nihalani is CEO at Plus91, a healthcare IT firm in Pune, India.
"While Japan does have a healthcare IT strategy setup, with benefits and stimulus funds, it is relatively new and yet to mature," he noted. "Health data digitization and electronic record keeping is still in its infancy. Japan does not boast of large scale electronic medical record coverage."
Every year technology trends continue to impact our decisions concerning the emerging solutions and technologies that we will explore. But the more health organizations that officially start their journeys toward electronic health information, the more their storage needs are significantly, immediately increased. Data associated with digital imaging, structure documents, unstructured documents, lab results, and several other data sets have required many to continuously reexamine their storage strategy and expand their capacity.
In recent months, a natural disaster in Asia caused significant downtime for some of the country’s leading storage and drive manufacturers, sending storage costs up. While this subtle change has not decreased the demand, many are beginning to plan for alternatives and potentials for future models that will provide a more cost effective way to store information.
Cloud-based storage is seen as the next destination for home and enterprise users when it comes to storing their data without the need of physical drives or servers locally. Similar to what DropBox, Dell, iCloud and now the new Google cloud-based storage platform, many have recognized the clear advantages to this new data destination.
￼Engagement is easier than it used to be. Technology has advanced to the point that keeping track of one’s health and staying connected with one’s care team is simpler than ever, for pretty much everyone.
Everybody's talking about accountable care nowadays. But providers aren't the only ones who need to be held accountable as we push off into the uncharted waters of care coordination and payment reform. The folks on the other side of that storied and sacred doctor/patient relationship have important responsibilities too.
It’s a refrain one hears over and over again, from the National Coordinator on down to smallest software start-up company: Only once a critical mass of people start thinking more about and taking more responsibility for their own wellness, can the health system transformation toward which we're all striving really come about.
The hard part? Making sure that actually happens.
As the role of the EHR is shifting to support next-generation business models like accountable care organizations and patient-centered medical homes, it's no secret some of their functions could use a little fine-tuning.
And, in addition to a more data-focused approach and an understanding of EHRs as care coordination platforms, Shahid Shah, software analyst and author of the blog The Healthcare IT Guy, believes EHRs need to support a specific set of characteristics to truly be successful in the years to come
The public is using social media to find answers to their health wants, needs and preferences, according to a US study by PwC.
The consultants surveyed over 1,000 people and found that one third used social media sites like Facebook, Twitter, YouTube and online forums for health-related matters.
Specifically they sought medical information, tracked and shared symptoms, and broadcast how they felt about doctors, drugs, treatments, medical devices and health plans.
Kelly Barnes, US health industries leader, at PwC said: "Health organisations have an opportunity to use social media as a way to better listen, participate in discussions and engage with consumers in ways that extend their interaction beyond a clinical encounter. Savvy adopters are viewing social media as a business strategy, not just a marketing tool."
It seems like every week, a hospital proudly unveils a new mobile app. But before you go and hire a mobile developer, ask yourself: Will a mobile app provide real value to users and will it advance your hospital's marketing and/or clinical objectives?
It's not enough to simply build a mobile app; people need to use it. It's important to keep in mind that while there are thousands of iPhone apps currently available, only 5 percent are still used one month after downloading.
Will your hospital's app provide enough useful information so that it will be one that people return to on a regular basis?