While there were over 38,000 attendees at HIMSS14, and there were some 95,000 tweets, so I was able to see a lot of what stood out from my armchair by some very diligent tweeting, which appears to be growing exponentially around Health IT.
Among several themes, the now usual suspects stood out: patient engagement, meaningful use, mHealth and interoperability. These are all very important, but what I noticed emerging was how each of these fit into a much bigger picture of decision-making driven by context and more transparent data.
Doug Fridsma, Chief Science Officer at the ONC, says, as Farzad Mostashari said in the past, the stages of meaningful use are intended to act as a vehicle to accomplish healthcare’s Triple Aim. Health IT is really moving toward accountable, value-based care, which ultimately has its success rooted in better decisions by patients, physicians and caregivers.The interoperability must ultimately lead to delivering more transparent cost and quality data in context.
Two programs, Aligning Forces Humboldt (Calif.) and Aligning Forces for Quality-South Central Pennsylvania, found increased transparency helped patients understand the system and how it worked, according to the brief. "The groups have found that clear expectations, structured meetings and asking patients for feedback through meeting evaluations increases the satisfaction of both patients and clinicians," the brief states.
Patients involved in their own care do a better job of communicating their own needs, according to the brief. Massachusetts Health Quality Partners, which serves the greater Boston area, created the Patient and Public Engagement Council to give providers feedback and foster patient-physician relations.
Aligning Forces Humboldt offers workshops that assist patients with management strategies for chronic conditions, such as diabetes, high cholesterol, heart conditions and obesity. "Initially, the program relied on word-of-mouth recommendations from enthusiastic alumni, public service announcements and newspaper articles to recruit attendees," the brief states. "Those efforts didn't go far enough, however, so program leaders began working with doctors' offices to refer patients with chronic illnesses."
Joe Kiani has been a leader in patient safety and healthcare innovation for more than 20 years. He is Chairman and CEO of Masimo Corporation, a global medical device manufacturer, and the founder of the non-profit Patient Safety Movement Foundation. His mission is to drastically reduce the more than 200,000 preventable patient deaths that occur in U.S. hospitals every year from medical errors and hospital acquired infections (HAI).
Consider the experience of Rob Long, a veteran writer and sitcom producer, as described in his weekly radio commentary on KRCW a few years ago: Two weeks ago, I found myself in the office of a hematologist — which is a word they use because the other word is “oncologist”...
Beyond information, many people in the midst of a medical crisis search for and find emotional support online. A survey shows people with rare disease are some of the most sophisticated Internet surfers
There are specific patient education departments in most major medical centers. What role do they play and how have they evolved over the years? I spoke with Louise Villejo, Executive Director at the Patient Education Office at the MD Anderson Cancer Center to get her thoughts on the topic.
During a Stanford MedX Live panel on healthcare entrepreneurship Tuesday night, someone on Twitter posed an important question: How can we better incorporate the patient’s voice into the development of healthcare IT?
Adrian James is co-founder of Omada Health, a venture-backed digital health company that designed a 16-week diabetes prevention program to help at-risk people develop healthier habits through social support, data tracking, personalized coaching and structured learning. It’s based on the Diabetes Prevention Program, which was tested in a 3,200-subject study and demonstrated that people with pre-diabetes could cut their risk of disease progression by losing weight through exercise and diet changes.
The former designer at IDEO explained that one of the first steps in creating Omada Health was getting user feedback, even before there was a product.
“We literally went out with a single printed piece of paper – it was this concept that we might be able to match people with pre-diabetes into small groups and usher them, in a virtual setting, through this clinical trial,” he said.
I gave a talk recently to a group of my peers about addressing the needs of patients after a diagnosis of cancer, emphasizing points where transitions occur — from treatment, to end of therapy, surveillance, recurrence, and extending all the way up to the end of life — and how important it is to consider the entire journey of a person with cancer, from patient to survivor.
One of my goals of this talk was to address the need for oncologists to engage those actually diagnosed with cancer, the most interested of the “stakeholders.” I asked my colleagues if they had heard of a movement afoot in medicine, that of patient engagement, and whether they knew of folks like David deBronkart (alias e-Patient Dave). I was met with a few nods, but mostly none had heard of either. In truth, I was surprised to see that the patient engagement movement had not achieved greater familiarity with my audience.
Improvements in healthcare information technology in the last decade have led to a fundamental shift in the way healthcare providers operate. The use of electronic health records is now widespread and healthcare professionals have access to immense amounts of data. While technology has improved clinical performance in many ways, patient engagement has certainly suffered a setback.
Today’s healthcare professionals are tied to technology. Whether documenting care at a computer terminal or looking up patient history on a tablet, clinicians are left with less time to engage directly with patients. In fact, data entry can take up to one-third of a clinician’s day.
Clinicians want to spend more time interacting with patients versus engaging with technology, and patients deserve it. By increasing the time spent working with and educating patients, clinicians can improve patient satisfaction, increase Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS®) survey scores, and provide a better overall patient experience.
A couple of weeks ago, Dave deBronkart says a friend of his was having "such a bad time" in a hospital. "She had to go walking down the hall to find her nurse because a half hour earlier, her IV had fallen out, and she got no responses to her call button," he says.
In this era of patient-centered healthcare, more and more importance is being placed on how a hospital communicates with a patient. Be it through a portal or mobile-optimized website, that connection ties into patient satisfaction rates and, eventually, the bottom line.
A new collaboration announced at HIMSS14 aims to rank all of the nation's hospitals on their patient engagement abilities, much like hospitals are now ranked for their health IT acumen or their beauty.
"The best hospitals realize the patient gets well outside the hospital," said Joanne Rohde, CEO of Axial Exchange. "They've been doing this long before Meaningful Use 1, 2 or 3 … and now it's time for the rest to catch up."
Axial Exchange, a Raleigh, N.C.-based developer of mobile engagement tools for hospitals and their patients, has been creating so-called Patient Engagement Indexes (PEIs) for specific states. At HIMSS14 last month in Orlando, the company announced a partnership with Becker's Hospital Review to expand that system to a national stage, with the rankings set to be released in May.
"Patient engagement is increasingly at the center of healthcare reform, and achieving excellence in clinical outcomes has been proven dependent upon enhanced patient involvement," said Lindsey Dunn, editor-in-chief ofBecker's Hospital Review, in a press reelase.
Common subjects frequently discussed during HIMSS 2014 were lessons learned and best practices around patient engagement. And in almost all the sessions I attended, the takeaway hasn't always been driving engagement with technology or mobile apps. In fact, out of all the recommendations and success stories, apps are just one piece of this complex, ever-changing puzzle to solve: What activates and engages patients now that it's a criterion in meaningful use stage 2?
The need for a patient engagement strategy comes from the common goal that many physicians and hospitals share around improving patient outcomes, reducing hospital readmissions and overall helping manage population health to address chronic disease.
To help patients reach and maintain their optimum level of health, healthcare professionals need to support and utilize the tools gaining prominence in our tech-savvy society. More importantly, they need to become primary motivators in healthy living, not just advisors in times of need.
Colorectal cancer - cancer of the colon or rectum – is one of the most commonly diagnosed cancers in the United States. According to a study published in the New England Journal of Medicine, removing precancerous growths found during a colonoscopy can cut the risk of dying from colon cancer in half. Less than half of ...
A visit to the dentist could one day require a detailed look at how genes in a patient's body are being switched on or off, as well as examining their pearly whites, according to researchers at the University of Adelaide.
1. Have patients start to monitor their health metrics with pen and paper.
One example in which I as a cardiologist engage patients initially is to have them start to manually keep track of their blood pressures (if a diagnosis of hypertension is suspected but not made, if medications are changed which might affect BP, or to attempt to correlate symptoms with BP). I observe a compliance rate of 100% with a request for a two-week log. At follow-up (either via the patient portal or in person) I review the record (I supply the patient with a pre-printed chart to fill out), reaffirm the importance of the data, and then perhaps move to discussions about monitoring via simple apps that they or their caregiver might use (even if unrelated to blood pressure).
2. Introduce mobile health apps for wellness first.
When discussing diet, medication adherence (especially when prescribing a new one), disease state education, or perhaps smoking cessation, I make it know that there are apps to assist in those areas. I give a list of the best ones and suggest that their caregiver if needed help with the download or use of the app. I show sample snapshots from the app store on my own phone. I believe that wellness apps are easier to introduce as engagement tools than specific disease apps (at least to the less digitally literate).
3. Discuss your philosophy as a physician.
After I introduce myself to a new patient (with the same degree of attention to the caregiver in the exam room), I discuss my practice philosophy of only recommending the minimal degree of testing and prescriptions (many patients mistrust physicians as prescribing testing or drugs because of financial incentives). I then go on to stress shared decision making which requires a partnership of honesty and listening. I believe this to be imperative as it not only sets the tone in a positive manner but establishes the importance of patient participation.
4. Learn about the patient as a person.
Knowing the caregiver support (or lack thereof) around a patient gives a physician the milieu in which shared decision-making is to play out. Critical barriers might exist which will ever prevent success without adjustments by the provider and/or the patient. Caregivers should be involved whether it is a near or distant interested relative, friend, acquaintance or other professional involved with the patient. A patient’s former or present occupation or hobby might impact treatment plans or give insight into educational and levels, and degree of independence.
5. Create buy-in from physician colleagues.
Discussing patient engagement within the context of everyday professional interaction is a great way to change culture one person at a time. In correspondences or conversations regarding a patient, “The patient, family and I have decided”, “I found the BP diary the patient filled out for me very useful” or “I recommended that the patient consider using such and such diabetes app” are non-threatening or proselytizing ways to convey how I view positively and embrace engagement.
Nearly half of ePatients living in the United States say the web has helped them get treatment faster, better communicate with their doctors, understand medications, or otherwise “CareHack” the health system over the past three years, according to new data published in EPATIENT 2015: 15 Surprising Trends Changing Health Care.
Without a doubt patient engagement is one of the more important trends in healthcare and health IT right now. Over the past few years the tools that look to enable patient engagement between providers and patients have changed markedly. It is important to note, however, that the tools themselves are just a small part of the story — they can go a long way toward improving patient engagement, though. The drivers of the patient engagement buzz are varied, but one big one is the federal government’s Office of the National Coordinator’s (ONC) Meaningful Use (MU) program, which is beginning to include requirements for very basic patient engagement services.
ONC’s MU Stage II requirements include at least three patient engagement related deliverables of providers. To meet Stage II, providers must give patients clinical summaries after each visit. They must use electronic secure messaging to communicate with patients on relevant health information with a minimum of 5 percent of their patients during the review period. They must also provide patients with the ability to view online, download and transmit information about a hospital admission and give them access to any health information about that patient the providers receives — within four days of receiving it.
Globally, industries spend millions trying to listen to the ‘voice of the customer’, and understand their needs. They then spend millions more in analyzing the information they have collected, understanding what the customer needs and then tailoring a product or service that will perfectly mirror that need.
An exception is the healthcare industry, where the primary mover is not the consumer, but the provider. This is despite major studies and research establishing that patient engagement is the key to better and more effective healthcare.
The ability to write something meaningful in140 characters, including a shortened URL, is the basis of Twitter. Over 500 million tweets go out every day to individuals who enjoy the simplicity, functional design, and speed of delivery that twitter offers, along with the ability to connect with others, collaborate and share ideas. To say that Twitter is viral is to understate the facts.
Twitter launched in March, 2006,has become the go to place . By the fall of 2013, there were over a billion registered twitter users who generate more than 500 million tweets daily. Since its inception there have been over 50,000,000 healthcare tweets; over 5,000 comments, and there are more than 1,000 common healthcare hastags.These tweets come from individuals, hospitals, physicians and other providers, health advocates, patients and caretakers. They offer advice and resources on every imaginable health topic from information about procedures and surgeries, to public policy and population management, to patient commentaries.
The ability to retweet someone else’s tweet and to send messages to people based on tweets merely expands the reach. Currently SPM has over 3,000 followers on twitter and the Journal of Participatory Medicine has nearly 2,000 followers. We also conduct tweet chats.