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The ways in which technology benefits healthcare
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Data analytics driving medical breakthroughs

Data analytics driving medical breakthroughs | healthcare technology | Scoop.it

Big data and other technologies are poised to start saving lives and enhancing quality of life for sick patients.

 

A hospital is usually a pretty busy place, but the neonatal intensive care unit at Toronto's Hospital for Sick Children has been buzzing with even more activity than is customary. Thanks to a new technology partnership, the hospital is working to use analytics to predict more accurately than ever before which premature babies are at most risk for disease and infection.

 

The hospital is in a study to monitor temperature, heart rate, blood saturation and blood pressure levels on preemies, collecting streaming data from electronic devices that monitor the premature babies.

 

Sick Kids, as the hospital is known, is in good company. Healthcare providers -- from insurance firms to hospitals to service suppliers -- are lining up to adopt advanced technologies to help them take better care of their patients, in many cases becoming more proactive and more personalized than ever before, with the hopes of saving money, too.

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Online oral health education tools: Part 1, Opportunity

Problem: Even people who have regular health-care visits often do not get preventive care and suffer poor oral health literacy.

 

Given the nature of common oral illness, dentists should be looking forward to the use of online personal health tools to improve patient oral health and enhance practice management and patient care efficiency. For years, policymakers have urged American health care to adopt Electronic Medical Records systems (EMR) and Personal Health Records (PMR) that remind doctors and patients about needed care and make it easier for doctors to share information with one another. Dentistry has lagged significantly behind. Increasingly, American health care is shifting to information- and network-based patient care. The slow but steady adaptation of the use of EMR, PMR, among other tools, is intended to address one of the biggest flaws in modern health care.

 

Solution: Use practice-based online tools to track patient self-assessments and dental visit examination outcomes to provide the most effective and efficient method for monitoring patient health and enhance practice management and patient care efficiency.

 

The very nature of common oral illness and the proven beneficial effect of timely preventive dental visits dictate that online health records could have tremendous benefit for promoting health literacy/behaviors and timely dental visits from birth through the senior years.

 

This is just the beginning. As we know, poor oral health is a cofactor for chronic health problems, such as diabetes, heart disease, stroke, pneumonia, low birth weight, and brittle bones. Additionally, medications prescribed for chronic health problems can be harmful for oral health, but online tools can alert primary physicians of the situation. Patient self-assessment and outcome data could help dentists and physicians bridge the communication gap that exists between the professions.

 

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Increase Patient Participation with Health IT

Increase Patient Participation with Health IT | healthcare technology | Scoop.it

Providers and patients who share access to electronic health information can collaborate in informed decision making. Patient participation is especially important in managing and treating chronic conditions such as asthma, diabetes, and obesity.

 

How EHRs Foster Patient Participation

 

Electronic health records (EHRs) can help providers:

Ensure high-quality care. With EHRs, providers can give patients full and accurate information about all of their medical evaluations. Providers can also offer follow-up information after an office visit or a hospital stay, such as self-care instructions, reminders for other follow-up care, and links to web resources.


Create an avenue for communication with their patients. With EHRs, providers can manage appointment schedules electronically and exchange e-mail with their patients. Quick and easy communication between patients and providers may help providers identify symptoms earlier. And it can position providers to be more proactive by reaching out to patients.

 

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Using the iPad as a telemedicine aid

Apple iPads are becoming ubiquitous (selling over 55 million of anything will tend to do that). They’re “evolutionizing” education, air travel, and even medicine, but most of these advances have stemmed from replacing lots of paper (e.g., textbooks, maps, patient charts) with a durable hard drive and a big screen. We’ve been testing a slightly more clever use for iPads on an ambitious client project: using the iPad as a novel telemedicine aid.

 

Telemedicine is a catchall term for administering healthcare remotely, i.e., when the patient and the provider are in different physical locations. In our client’s case, this scenario is caused by timing. Research participants with a rare genetic lesion and their families are flown to one of two sites in North America for an extensive imaging evaluation, but they have to return home before it’s possible to have a local neurologist review any clinically-relevant findings with them. A phone call wasn’t going to cut it, since the neurologist would typically review pictures with the family (an MRI scan, for example) … and most people can’t conjure up an anatomical model of the human brain from memory.

 

Using a computer seemed logical, but not every family has a computer with an Internet connection and video camera, and troubleshooting videoconferencing software can be a nightmare. Laptops suffer from the same limitations, and are fragile and difficult to ship, to boot. Enter the iPad 2 3G. When paired with an inexpensive data plan, the iPad has a decent wireless Internet connection just about anywhere in the US. It has a built-in video camera. And it’s durable, easy to use, and inexpensive to ship (in a padded envelope)!

 

You’re probably (should be) thinking, “What about HIPAA?” HIPAA prevents the disclosure of any medical data for research (or other) purposes. Our research participants’ imaging results are considered Protected Health Information (PHI) and are protected by law from disclosure. Sending them on an electronic device across the country isn’t a safe (or smart) option. So, we used Fuze Meeting, an iPad app that enables secure videoconferencing and image sharing. The neurologist uses Fuze on their local computer to walk the family through any number of images or videos using annotations and other built-in visual aids to ensure the family is looking at the right place. The Fuze Meeting iPad app displays the images and annotations to the family in realtime, and even allows the family to zoom or reposition the images. And since the images are never downloaded to the iPad itself, there’s no risk of PHI falling into the wrong hands, even if the iPad does. Once the consultation is complete, the participant simply mails the device back to the research site.

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A New World of Healthcare Apps

A New World of Healthcare Apps | healthcare technology | Scoop.it

Since 2006, we've been tracking the re-birth of health online. Of course it never really went away, but the ehealth frenzy of the late 1990s really only left WebMD standing. Few were online to actually manage their health. Most were just reading about it. That's all changed. We're now in a world where the cloud, ubiquitous smart devices and sensors are all coming together to become what we call "unplatorms" for "apps" and the data that is flowing over them. That health data is starting to be captured and shared between them in a "data utility layer."

 

What this all means is that there's huge number of devices and applications available to be used by all types of players in the healthcare sector. And that use is starting to grow. We picked three areas that are on the cusp of becoming an everyday big deal in health.

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The Knowledge Translation Toolkit

The Knowledge Translation Toolkit | healthcare technology | Scoop.it

The tools in this book will help researchers ensure that their good science reaches more people, is more clearly understood, and is more likely to lead to positive action. In sum, that their work becomes more useful, and therefore more valuable.

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Investigation into the Use of Short Message Services to Expand Uptake of Human Immunodeficiency Virus Testing, and Whether Content and Dosage Impact

Investigation into the Use of Short Message Services to Expand Uptake of Human Immunodeficiency Virus Testing, and Whether Content and Dosage Impact | healthcare technology | Scoop.it

South Africa has one of the highest human immunodeficiency virus (HIV) prevalence rates in the world, but despite the well-established benefits of HIV counseling and testing (HCT), there is low uptake of HCT. The study aimed to investigate the effectiveness of using short message services (SMSs) to encourage HCT while interrogating the impact of altering SMS content and dosage (the number of SMSs).

 

 

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Pain Management and Telemedicine | HealthWorks Collective

Pain Management and Telemedicine | HealthWorks Collective | healthcare technology | Scoop.it

I do think there are pain management practices that could provide quality healthcare to chronic pain patients in rural areas. And the telemedicine pain doctors might do a lot to help these patients be better able to function. But…..

 

I know when I have a pain (and thankfully I don’t have any that is chronic), I want it to stop hurting. Narcotic painkillers can help overcome pain, but they are only supposed to be a temporary solution. We all know why – they are addictive. Constant use causes other physical problems like constipation.

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Mobile-based communications system improves hospital care

Replacing phone- and pager-based communication systems with smartphone- and tablet-based systems reduced length of stay and adverse event calls at a large UK teaching hospital, according to a new study published in the journal BMJ Open.


The new system, which ran over a Cisco wireless network, routed incoming calls through a single PC, from which calls then were delivered directly to physicians' tablets and smartphones specially purchased for the trial. The new system has about three steps--a far cry from the 10-plus-step process used previously. Under the old system, nurses paged a call coordinator, who called back the nurse, determined the need, paged the physician, received a callback, confirmed the patient need, and assigned the task to the physician, the study shows.

 

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As Health Care Changes, So Must its Technology

As Health Care Changes, So Must its Technology | healthcare technology | Scoop.it

Health care is changing dramatically. Clinicians are moving into larger groups, managing whole populations. Health IT must change to meet these new needs.

 

the new environment asks more from its technology tools. Of course, modern Electronic Health Records (EHR) need to cover the basics. They must be able to be efficient, intuitive, and work alongside the clinical workflows of everyone in the practice in order not to be obtrusive (and therefore resisted). They need to allow order entry – from sending electronic prescriptions directly to pharmacies, to ordering lab tests electronically, to ordering x-ray and imaging studies electronically as well. And they need to do these things in ways that allow for obtaining insurance (or medical group/PCMH/ACO) authorization when necessary. They need to capture outside data, like lab test results, imaging results, and correspondence from consultants, and integrate these into the EHR record.

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6 Reasons why mHealth is different than eHealth

In Mexico, it’s illegal for patients to access their own medical records, and 9.1 percent of Mexicans have an Internet connection at home. 80 percent of them have at least one cell phone.

 

Conditions like this don’t stifle innovation, they ignite it, and it’s one of the several reasons I think mHealth (“the use of wireless communication devices to support public health and clinical practice”) is different than eHealth (which I’m referring to as desktop Web/computer interaction in health/health care).

 

I credit Susannah Fox, the Internet’s Informant General, for stimulating the thinking. In 2008 at Health 2.0 in San Diego, she said, “Recruit doctors, let e-patients lead, go mobile” and the data she has been generating since has ceaselessly has been pointing to that reality.

 

More recently, Washington, DC, hosted the mHealth Initiative Networking Conference last week, and this week, Health Affairs hosted a briefing on their latest issue on E-Health in the Developing World (side note, I know I’m behind in noticing this, but I love HealthAffairs new print form factor – less tome-y and more open).

 

The mHealth Networking Conference was remarkable for me in terms of the spark I noticed on the part of the attendees and the slightly different focus – a little more public health-y, a little more do-great-things-for-society-y. And, I’m going to say it, a little more exciting for someone like me because of the possibilities that go beyond the desktop web. To learn about them in the City where people believe everything is possible, because it is, is just icing on the cake.

 

So here’s my list:

#1: When we talk about the web, we still worry about the people who are just not online. According to Susannah’s team, its hovering at 26 %. mHealth is different, everyone has a cell phone or is going to get one, relatively speaking. If you compare use visually, the cell phone thermometer shows much greater penetration – all groups are “pushed up” to higher degrees of access.

 

Speaking of Mexico and the developing world, the parallels are relevant in the United States to vulnerable populaition, and this is another key difference. Desktop web access favors more educated, more affluent people. There’s an inverse relationship when it comes to wireless. Look at this data from December: If you look carefully, you’ll see something amazing. Access statistics for Black and Hispanic respondents are higher for wireless access to the Internet than for Whites. It’s almost as if the “haves/have nots” are reversed. For people interested in reducing disparities, this is…kind of huge. That’s

difference #2.

 

Difference #3 has to do with ease of set-up. When I speak with iPhone developers or people involved in mobile, I hear the words “difficult, challenging,” which is different than what we heard in 1995 when anyone (me included) could code an HTML page and put it up.

 

Difference #4, when we talk about the web, there’s not a discussion of telecommunications companies and their innovation. When we talk about mHealth, we have to include telecommunications companies. This year at HIMSS10 , in Atlanta, it’s not Sanjay Gupta, MD (whose work I have great respect for) that I want to see speak the most. it’s Dan Hesse, CEO of Sprint/Nextel. People with telecommunications experience, in my opinion will be very important moving forward. In a analogous way, I am as drawn to the CTIA as I am to AMIA .

 

Difference #5, Reverse Innovation – Unlike the web, a lot of the “cool” stuff has already been pioneered, outside of the United States. Susan Dentzer said it best at the Health Affairs briefing: ” Clearly the US is the developing country when it comes to mHealth“. The term reverse innovation comes from General Electric (this article from Harvard Business Review explains it) , and it means that a lot of the inventing to be done is happening in India, China, South America, and as the article linked to above points out, in Mexico. What may work best is something that comes from a place with far less resources than we have. Kind of what health care, a resource-poor industry when it comes to innovation at the level of public health and primary care, needs.

 

Difference #6, it’s more personal. Some of the apps we saw last week, and others I am hearing about, are things that might not work on the desktop web so well, because a desktop or laptop is not as “personal” a device. The idea of storing information on a web site and forwarding to your doctor seems to make more sense on a mobile phone, because it’s something you hold that’s yours, that you can “share” with someone. Not the same for a web site on a computer.

 

I want to clarify that this is not 6 reasons why mHealth is better or has more scientific evidence behind it. This is just differences. I’ll report on two great papers in the Health Affairs issue on this shortly.

 

Original Article at http://www.tedeytan.com/2010/02/18/4731

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“Design For Hack” in Medicine

“Design For Hack” in Medicine | healthcare technology | Scoop.it

Medical aid is a good story. We’ve all seen articles about well-meaning groups donating X-ray machines and incubators to needy clinics in the developing world. What we don’t see are those same devices when they fail as little as six months later — or even dead on arrival — because they weren’t designed to operate in these environments.

 

About 90% of medical technology that reaches poor countries is hand-me-down equipment designed for first-world facilities. Expecting it to keep working is like expecting a used Rolls-Royce to survive the Paris-Dakar Rally. And after it malfunctions, it’s usually junked.

 

In response, some designers have felt that we need to send over cheaper versions of the high-end equipment, the equivalent of economy cars. But what these clinics really need are Land Rovers — devices designed to be rugged, accessible, and easily repairable in the field.

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How EMRs Will Change in the Near Future; Avoidance of Monolithic Systems

How the role of EHRs will change: The best EMRs will be those that become the central “dashboard” around the most complex healthcare workflows and begin to really become “coordinators” amongst multiple systems instead of a monolithic application. Clinicians really need to understand that their EHRs need to be their patients’ social health record and relationship management system and not just their chart management system.

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Health Systems Ignore Patients at Their Own Peril

Health Systems Ignore Patients at Their Own Peril | healthcare technology | Scoop.it

“The most important member of the care team is the patient.” That has been a statement one has heard in healthcare for decades, yet it has never been more important. Why? It is next to impossible to succeed in the value and outcome-based healthcare reimbursement model every private and government payor is driving towards (with or without Obamacare).

 

In my experience reviewing or implementing over 100 health IT systems, the core purpose of legacy healthIT systems is crystal clear — their job is to get as big a bill out as quickly as possible. Why wouldn’t it? The much-criticized fee-for-service model that incentivizes activity over outcome has driven that outcome. In fact, it would have been irrational for healthcare providers to demand systems that did otherwise. The fuzzy image below is how a patient looks to healthIT systems where it has one point of clarity — the billing codes associated with the patients. That may be good for billing but unfortunately that is at the heart of healthcare’s hyperinflation. Consider that since the 60′s, while all non-healthcare expenditures increased 8x, healthcare increased 274x.

 

While there is great ambiguity about the future of healthcare, there is one certainty: healthcare will be paid based on some blend of value/quality/outcome and a shifting away from the “do more, bill more” reimbursement model. One can’t overstate the scale of this change and what it means for healthcare providers and the organizations that support them. This will make the shift from analog to digital media look trivial.One similarity to the analog-to-digital media shift, however, is healthcare will also face deflationary economics that will produce many winners and losers.

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Meaningful Use Provides Hospital EHR Vendor Lock In

One of the unintended consequences of meaningful use is that it provides a real hospital EHR vendor lock in. Certainly hospital EHR vendors have a pretty significant lock in even without meaningful use. Saying that switching hospital EHR software is a large project is a supreme understatement. However, if that wasn’t lock in enough, meaningful use makes it so that I can’t imagine a single hospital switching EHR software during the 5 year meaningful use cycle.

 

In a Meaningful Use Monday post on EMR and HIPAA, Lynn Scheps covered the details of Switching EHR software in the middle of meaningful use. So, yes it is technically possible and CMS has covered those that do end up switching EHR software. As the meaningful use stages progress I could even see this happening relatively frequently in the ambulatory EHR arena. I don’t see this happening at all in the hospital EHR arena.

 

You might ask why? I can’t imagine a hospital going to the effort of reconciling the details of meaningful use between two systems. Not to mention the implementation time for a hospital EHR system is so long that you’d likely lose out on a year of meaningful use money anyway. I don’t see any hospital CIO making this choice.

 

I made the argument in a previous post that much like ERP software, there will be an opportunity for some EHR software to displace the current vendor. I suggested this is most likely during the renewal or upgrade period. I still think this is sound reasoning and would be the time a hospital CIO could make the case for change. Although, I’m sure that meaningful use and the EHR incentive money will likely mean that many hospital CIOs take the upgrade cost on the chin instead of switching software.

 

Makes me wonder if EHR vendors will use this to their advantage when it’s time to deal with renewals and upgrades. I’d hope this wouldn’t be the case, but I won’t be surprised if it happens.

 

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Why social media tools are a must-have for physicians

Why social media tools are a must-have for physicians | healthcare technology | Scoop.it

With one-third or more of consumers using social media to obtain and share health information, physicians who don't use the technology risk getting left behind, according to several recent posts. 

 

Without a digital presence, physicians risk:

 

losing patients who prefer online communication

 

missing opportunities to brand themselves as experts

 

not reaching potential new patients through social media channels

 

missing the chance to dispel health myths and clarify correct and appropriate health information

 

failing to hear what patients have to say about their health, healthcare in general and other topics that can influence how a physician practices medicine

 

passing up the opportunity to respond to negative reviews of their practices

 

 

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Branded pharmaceutical websites generate highest lifts in Rx conversion and adherence

Branded pharmaceutical websites generate highest lifts in Rx conversion and adherence | healthcare technology | Scoop.it

"Over the years, our benchmarking studies have proven the impact that online marketing continues to have on increasing consumer awareness and favourability toward health brands, ultimately driving treatment," said John Mangano, vice president for comScore Health and Pharmaceutical Solutions. "As we continue to provide the industry standard for measuring online pharmaceutical brand lifts, we're also excited to introduce significant innovations to our methodology that will allow marketers to quantify not only the incremental conversions driven by their online campaigns, but also the incremental impact of each ad exposure in driving overall brand lift."

 

Branded site visitation yields most significant lifts in new patients and Rx adherence
Supporting previous benchmarking studies, the most recent findings indicate that exposure to online display ads yields a nominal lift in brand awareness among prospects, with a higher lift seen for exposure and interaction with rich media ads. However, branded website visitation continues to have the greatest impact for both prospects and patients, yielding significant lifts not just in awareness, but also in favourability and conversion. Existing patients of a pharmaceutical brand who visited the brand site increased their refill rate by 14.7 percentage points compared to the control group. Prospects who visited a branded site also saw a positive increase of 8.9 percentage points in beginning treatment compared to those with no exposure to the site.

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Online Communities Accelerate Adoption of Best Practices for Quality and Cost Savings

Online Communities Accelerate Adoption of Best Practices for Quality and Cost Savings | healthcare technology | Scoop.it

What is an online community?

 

Whether public or private, an online community is simply a place for people to connect and share ideas. It differs from a landing page or a website in that participants engage in various tangents according to their interests. An online community can be based around professional roles, emerging technologies, or initiatives like healthcare quality. Online community members typically connect with experts and share research and their own experiences to arrive at a collective understanding of best practices.

 

Critical Success Factors for Online Communities

 

Getting from here to there can be tough for

healthcare providers with little experience in web-based collaboration. Successful online communities employ three critical success factors:

 

Member engagement. Rather than posting information on a static website, a successful online community is supported by community managers who can post resources, synthesize comments, and keep the conversation going with relevant questions.

 

A framework of tools. The technological underpinnings of a successful online community provide various ways for members to connect and collaborate, from taking polls to posting content and hosting group discussions.

 

Revealing data. Reports can provide healthcare professionals with constant feedback so they can tailor initiatives swiftly.

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Design of a Phone-Based Clinical Decision Support System for Resource-Limited Settings

Design of a Phone-Based Clinical Decision Support System for Resource-Limited Settings | healthcare technology | Scoop.it

This paper uses a multi-method approach to document four failure modes that
can impact CDSS implementations. Building from six design principles, it describes a phone-based system designed to address these failure modes and comes to six core endings that are important for mobile systems implementers and health care providers.

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5 steps to unblocking social media at your hospital

5 steps to unblocking social media at your hospital | healthcare technology | Scoop.it

According to QuantiaMD, 67 percent of physicians use social media professionally, and the ability to always be connected is essential to making online social networking manageable. Health care professionals may eventually fall behind in their social networking efforts if hospitals continue to have those capabilities blocked.

 

Below are the first steps to beginning the process of unblocking social media at your hospital.

 

1. Create a committee

Invite those with varying backgrounds
Develop a plan of action

 

2. Examine the reasons why social media is blocked

Ask why
Identify fears and misconceptions

 

3. Reach out to peers and competitors

Listen and learn what is working
Ask them directly of their experience with unblocking

 

4. Create a Social Media Policy

Be concise and clear
Publicize the policy

 

5. Prove the benefits of social media
Discuss the latest studies and trends; visit stopblocking.org
Provide measurable numbers; speak the decision maker(s)' language
Identify social media as a natural evolution of communication

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mHealth Developers: Take a Minute to Remember Your Audience

mHealth Developers: Take a Minute to Remember Your Audience | healthcare technology | Scoop.it

According to market research from RNCOS, physician adoption of mobile devices in healthcare is expected to reach 81-85 by the end of 2012 as a result of device improvements, increased data speeds and decreased costs.

 

To meet this explosion in device usage and adoption in the healthcare industry, developers and independent software vendors (ISVs) must understand the key similarities and differentiators between an app for the consumer audience and one for the clinical audience. As you begin the design process, keep in mind that just because an app is useful for the consumer user doesn’t mean it’s going to resonate within the confines of the medical community.

 

For example, while you and I may use Siri as our daily digital assistant, the reality is this same technology doesn’t resonate with the everyday practitioner because of distinct differences in ontology and basic support needs as it relates to their specific job duties. For these reasons, I have outlined some important things ISVs and developers should be honing in on as they develop their medical applications

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HealthIT Standards 101: The EDI Standards

This is the second in a Series I’m calling HealthIT Standards 101. In this post, I’ll discuss the EDI standards used in Healthcare IT. A quick disclaimer here: I'm not much of an EDI standards geek outside the HL7 space. While I know HL7 very well, I have only read NCPDP and X12 specifications.

 

Electronic Data Interchange Standards in Healthcare IT


There are a number of standards used in healthcare that work similarly and are based on Electronic Data Interchange standards. These standards are designed to be independent of the communication technology, and simply describe the syntax and format of communications in terms of the text characters used to represent the information.

 

A unit of communication is described as a transaction or a message depending on which standard you are reading. I’ll use the term message in this post to describe both. There are two EDI standards from which these standards originate: UN/EDIFACT, and X12. The NCPDP Script standard used for ePrescribing in the US still retains its EDIFACT origins and syntax. HL7 Version 2 messages used for a variety of Healthcare integration works very similarly to the EDIFACT standard (in fact, you can use a similar processor for both HL7 and NCPDP standards). HL7 messages don’t follow the EDIFACT syntax rules for message headers or escaping special characters.

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Are there different types of personal health records (PHRs)?

Yes, there are two kinds of personal health records:

 

There are standalone PHRs where patients fill in the information from their own records and memories and the data is stored on patients’ computers or on the Internet.


There are tethered, or connected PHRs, which are linked to a specific health care organization’s EHR system or to a health plan’s information system. The patient accesses the information through a secure portal.

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Is mHealth at a crossroads?

A little over two years ago, I wrote a cheerlead-y piece on mHealth entitled “6 Reasons why mHealth is different than eHealth” (most of the stuff I write on here is cheerlead-y, everything except keeping secrets from patients, I don’t cheearlead that). I just reviewed it again, and the 6 reasons weren’t all reasons why mHealth is “easier,” just different. Several aspects of mHealth are more difficult than eHealth.

 

It’s now two years later and what has changed? I was graciously invited to a dialogue organized by the National Institutes of Health Public-Private Partnership Program on mHealth. Thank goodness this program has a web site so I don’t have to describe what they do, and thank goodness Barbara Mittleman, MD said, “Of course” and set up a hashtag immediately when I asked if I could tweet (it’s #nihmhealth).

 

If the definition of innovation is “a good idea executed well“, then maybe mHealth is at a crossroads, just because all the good ideas out there are not fully actualized across the health space.

 

I’ve been checking in on mHealth now and then over the past two years and it’s undeniable that it is being woven into health care. Maybe not as fast as people would like, but it is happening. In 2010, you couldn’t e-mail your physician at Group Health Cooperative or Kaiser Permanente from your mobile phone. Now over 9,500,000 people can (see: The mHealth app from @GroupHealth promotes what people want : A relationship with their doctor“ and “Siri, email my doctor“) , as easily as they would access their doctor via the web. I don’t have data on the Kaiser Permanente experience yet, but as soon as I do, I’ll post it here.

 

Vanity data or actionable data?

 

Actionable and/or Vanity

Emailing your doctor, making appointments, and reviewing lab test results make common tasks much easier. Then there is this. On the left is the device I use to quantify myself, on the right is the device+software that an awesome colleague of mine uses to quantify themselves. As I am reading Eric Ries The Lean Startup (more on that soon), I am reminded by the difference between “vanity metrics” and “actionable metrics.” I don’t which is which for whom and I don’t know what the population breakdown is for people who need what.

 

Individual behavior or social determinants or both?

My other sojourn since 2010 has been to understand social determinants of health better, the “causes of the causes” of poor health. If the impacts of those are far greater than individual behavior choices, what are the apps yet to be written that take this into account? What apps could be created to give the voiceless a voice, and/or impact community conditions in addition to/instead of individual behavior.

 

As I have said here many times (and I will repeat), “I am not that smart and my ideas are not that unique,” which means these desires are shared by many people I have spoken to, which also means we are going to get there.

 

I liked the reframe of my comment “Is mHealth at a crossroads,” as “Is medicine at a crossroads,” which I think is a fair way to look at things. As I have said here many times I am not that smart and my ideas are not that unique, which means these desires are shared by many people I have spoken to, which also means we are going to get there – to good ideas executed across social strata, to influence individual behavior as well as to reduce health inequalities.

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Using RSS to Create a Digital Dashboard for Lab Clients

The concept of a "digital dashboard" has been discussed since the 1990s. The goal was to create a cross-platform IT solution that gathered and integrated data from multiple heterogeneous systems, thus standardizing communication and data access. Such a product has been long anticipated but never truly realized. Bill Gates discussed the idea with emphasis on XML during his Comdex ’99 keynote (link here). Below is an excerpt from his lecture.

 

We can also let you walk up to your PC and see the things that you care about, not just this Web page or that Web page, but the things that you've pulled together. And that's not going to be just information from the Web, or just information from your local computer, or just information from your corporate service, it will mix all of those things. You want to mix all those things together...The Digital Dashboard is the concept that allows you to do that. And, again, it's very dependent on this XML approach so that Web sites aren't just places you go to look at, but they're places that your Digital Dashboard can go and ask for their XML, and then put that in the comprehensive presentation.

 

Unfortunately, a true digital dashboard platform has not even been defined yet alone been executed. End users must often browse dozens of resources to gather the information required to perform their daily tasks. It has been suggested that RSS might provide a technical foundation for the digital dashboard. 

 

Feeds can be created to provide metadata across applications of any kind. For example, RSS can enable IT managers to view a “snapshot” across all of the systems within their enterprise. This would ultimately allow a user to monitor his or her internal system resources, an LIS for example, along with email and industry news feeds. For the laboratory information niche, RSS may be a useful tool to enable communication between a laboratory and its client physicians. Customizable, dynamic, feeds could be built to directly notify a physician-client of a laboratory about the following: new (i.e., unread) lab test results, policy changes within the laboratory such as reference range updates, and regulatory changes pertaining to the lab.

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