E-HEALTH - E-SANTE - PHARMAGEEK
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Demain, la médecine sans médecin ?  #esante #hcsmeufr #digitalhealth

From usbeketrica.com

Le progrès technologique dans le secteur de la médecine va-t-il faire disparaître la figure du médecin ?
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«Un colis express est mieux suivi que la santé d'un patient» (Dr Koen Kas)  #hcsmeufr #esante #digitalhealth

From www.medi-sphere.be

Connu en Flandres comme auteur d’un ouvrage un rien provocateur 'Nooit meer ziek’, ce professeur en oncologie et futurologue de la santé nous livre quelques réflexions pour passer de la 'sickcare' à la 'healthcare'.
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4 Trends In #DigitalHealth To Keep An Eye On In 2018  #hcsmeufr #esante

From www.forbes.com

What are digital trends in population health? This question was originally answered on Quora by Nitin Goyal, MD.
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La France attend le déploiement de la e-santé  #hcsmeufr #esante #digitalhealth

From www.lopinion.fr

Le marché de la e-sante est en pleine explosion. Pour le commun des mortels, la première manifestation de la révolution technologique en cours se matérialise dans les objets connectés qui envahissent notre quotidien. Il y aurait actuellement 15 milliards d’objets connectés dans le monde, contre 4 milliards seulement en 2010, selon l’Institut de l’audiovisuel et des télécommunications.
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La technologie ne va pas faire disparaître le médecin #hcsmeufr #esante 

From www.lespecialiste.be

«La technologie ne va pas faire disparaître le médecin. Elle va le rendre plus disponible pour s’investir dans l’humain, l’accompagnement du patient...», selon Philippe Coucke, 

Pour pouvoir travailler dans les meilleures conditions le médecin doit bénéficier d’une structure avec des systèmes intégrés, une acquisition des données dans des formats standard, un bon stockage et une fine analyse des données et surtout une sécurité et une sauvegarde de la vie privée. Pour lui, il faut «associer le big data à l’intelligence artificielle». Actuellement, le programme d’intelligence artificielle IBM Watson est déjà en mesure, en fonction du profil de pathologie encodé, de proposer dans certains cas le meilleur choix thérapeutique. Pour lui, la médecine de demain devra donc plus que jamais être davantage préventive, prédictive, personnalisée et participative...

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Santé connectée : 4 chiffres à connaître #hcsmeufr #esante #digitalhealth

From experiences.microsoft.fr

Big data, wearables, dossiers médicaux numérisés, télémédecine… La santé connectée, quelles perspectives pour les entreprises? Le point en 5 chiffres clés.
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» E-santé : l’ANSM crée un un comité scientifique sur la cybersécurité des logiciels dispositifs médicaux #hcsmeufr #esante

From www.mypharma-editions.com

L’Agence nationale de sécurité du médicament et des produits de santé (ANSM) a annoncé la création du premier comité scientifique spécialisé temporaire (CSST) sur la cybersécurité des logiciels dispositifs médicaux (DM).
« Les experts externes qui le composent sont chargés de proposer des recommandations pour garantir un niveau minimum de sécurité des logiciels utilisés dans le domaine médical face aux menaces de malveillance numérique », indique l’ANSM dans un point d’information.
Un nombre croissant de dispositifs médicaux, qu’ils soient utilisés par des professionnels de santé à l’hôpital ou à domicile par des patients, sont aujourd’hui connectés. Ils peuvent donc partager des informations à travers des liaisons sans fil (Bluetooth, Wifi) ou par connexion physique à un réseau internet.
Les fonctionnalités de ces dispositifs couvrent l’échange de données (imagerie médicale, résultats de biologie), le pilotage du dispositif (programmation de pompes à perfusion ou de dispositifs implantables actifs), le suivi du patient à distance (surveillance de signes vitaux) ou la maintenance des produits.
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E-santé: les Français partagés sur l'usage des nouvelles technologies #esante #hcsmeufr

From www.bfmtv.com

Un sondage mené pour l’Observatoire Cetelem montre que l'e-santé est perçue comme une source de progrès et d’amélioration à de nombreux égards, notamment en matière de télémédecine. Mais des réserves subsistent toutefois notamment face à la question épineuse de la collecte et du partage des données de santé.
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The FDA Is Tackling Digital Health With the Help of Apple and Google  #hcsmeufr #esante #digitalhealth

From www.fool.com

The U.S. Food and Drug Administration (FDA), which is responsible for drug approvals, medical devices, and the food supply in the U.S., has announced a pilot project aimed at updating the process for approving software-based medical apps and devices. 

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HEALTHCARE 2.0: WHAT CAN DIGITAL DO FOR YOU?  #digitalhealth #hcsmeufr #esante

From nj.digital

Health professionals have taken particular interest in the internet trend as more practices begin to implement tools that will effectively improve doctor-patient engagement and interaction. Digital is a primary influence guiding patient choices and the patient journey starts with searching the web.  According to Google’s Digital Journey to Wellness study, 77 percent of patients use search engines prior to booking appointments.

Google partnered with Compete, Inc. and fielded over 500 hospital researchers to understand what influences hospital selection and what role digital plays in the journey. Digital marketing content was the key decision-making influence when patients booked appointments. 

Patients response data concludes digital content is indispensable. In fact, with 77% of users using search before they book an appointment, patient web searches drive three times as many valuable visitors than other traffic sources. What does that mean for healthcare providers? A strong online presence and positive reputation is critical, and generates conclusive patient leads.

Patient’s love digital and in the digital world– content is king.  Eighty five percent of patients booking appointments said digital content was the primary factor that influenced their decision making. Paid search ads, social media and quality search engine optimization are vastly influential as well, generating unique search paths that lead to valuable patient-doctor outcomes.  Online videos and blogs also play a pivotal part in patient engagement.  

Healthcare Industries, as well as other industries, have seen how the digital world has evolved to what it is today. With ever-changing digital platforms, it is important to keep your patients in mind through their digital journey. From website optimization to social media management, more and more patients are depending on the web to choose Hospitals, Specialists, and treatment centers.

 

For more insight, research and trends about the digital impact on healthcare industries, you can join us on October 18th 2017 for a live-stream event partnered with Google. During this event, specialist from Google will be taking a deep dive into digital marketing for Healthcare and Insurance Industries.

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La "révolution numérique en santé" érigée en priorité pour lutter contre les déserts médicaux  #digitalhealth #hcsmeufr #esante

From www.ticsante.com

Premier site français d’information en continu sur les technologies de l’information et de la communication (TIC, NTIC) dans la santé
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La France attend le déploiement de la e-santé  #digitalhealth #hcsmeufr #esante

From www.lopinion.fr

Objets connectés, Big Data, intelligence artificielle… Les avancées technologiques sont colossales dans le domaine de la e-santé. La France ne parvient pourtant pas à passer le cap de l’expérimentation, faute d’avancées en matière de dossier médical partagé et de financements. Le temps presse.
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Laurent Alexandre: «La protection des patients nous condamne à être une colonie des géants du numérique #hcsmeufr

From www.lopinion.fr

« Les GAFA ne sont pas des prédateurs, mais des visionnaires. L’Europe n’ayant que des consommateurs à défendre, alors que les États-Unis et la Chine ont de puissants acteurs industriels, elle étouffe les opérateurs »
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Attitudes towards the impact of digitisation and automation on daily life #hcsmeufr #esante

From ec.europa.eu

The European Commission has published a Eurobarometer survey presenting European citizens' opinions on the impact of digitisation and automation on daily life. European citizens see digitisation and automation primarily as an opportunity but call for investment for better and faster internet services as well as effective public policy to accompany changes, in particular in areas such as employment, privacy and personal health. The results also show that the more people are informed or use technologies the more they are likely to have a positive opinion on them and to trust them.
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Healthcare: Europe must get ready for the digital revolution now, says EESC

From www.eesc.europa.eu

Digital healthcare is around the corner. It will bring a sea change to our health care systems, in principle positive change, provided that a few basic political choices are made at European level before it is too late. This was the main conclusion of an own-initiative opinion entitled Impact of the digital healthcare revolution on health insurance, adopted by the European Economic and Social Committee (EESC) on 21 September.                                         

The digital revolution will radically change the way healthcare is provided in the next few years from a system based on cure to one focused on participatory, preventive, personalised and even predictive medicine, the so-called "4P medicine". Technology will sweep across the sector and change the way all players work – health professionals, pharmaceutical industries, hospitals, medical research centres, health insurance (such as mutual organisations) and of course citizens. In 5 to 10 years' time diagnoses will be made by machines, allowing doctors to focus on the relationship with their patients. People will be more and more in control of their health, thanks to a wealth of applications and devices providing information about health status. Genome mapping and other major scientific breakthroughs will make people aware of their genetic risks and able to adapt their lifestyles accordingly.

All this is - in principle - good news. Yet there are some potential threats lurking behind this revolution – first and foremost the risk that it may exacerbate social differences and widen the digital divide between those who have access to digital health and those who do not. This is why it is vital to act today to shape the healthcare systems of tomorrow. "Solidarity is the cornerstone of European healthcare systems, whether in old or new Member States. Health must continue to be seen as a common good– a good belonging to the public as a whole", said opinion rapporteur Alain Coheur, director of European and International Affairs at Belgium's National Union of Socialist Mutual Health Funds. "It is important that we retain our national health services and this will only happen if digital technology is used to activate our fundamental rights – the right to information, the right to healthcare: these are the keys to our social welfare systems."

Currently European healthcare systems are based on the pooling of risks and the fact that so far it has been impossible to predict when a risk would become a reality. People pay based on their means and receive according to their needs. This is particularly true of public healthcare. Tomorrow, however, all this could change, especially in private insurance, which is based on risk selection. With predictive medicine, profit-making insurance companies might want to personalise someone's risk profile, for instance on the basis of the likelihood that they will contract cancer in 5 or 10 years' time: "That is why we need to ask ourselves the question: what kind of health system do we want to have in Europe tomorrow?", argued the rapporteur. "Do we want equal access for all European citizens or are we going to go down the road that the USA has taken, where insurance dominates the market and, once you have had two illnesses, you will no longer be covered? If that is not the model we want, we need to state it clearly, because this is what could happen with digitalisation."

Mr Coheur also warned against the danger of transferring too much responsibility to patients as a result of the digital revolution: with all the information made available, they will end up being totally responsible for their own health. "That may be a valid objective, but we can't possibly be in charge of all the things that contribute to our health. There are personal life choices we can make, but there are also many external factors over which we have no control – for instance the use of pesticides in farming or exposure to air pollution", stressed the rapporteur.

Finally, another key issue that the EU needs to address, in the EESC's view, is the protection of health-related personal data. Sharing a patient's data with and between health professionals can help improve treatment. But, to be able to share their health data, people must themselves have a proper understanding and be able to give their informed consent to healthcare professionals for use of the data. This informed consent is vital, but there is still a lot of vagueness as to how healthcare data can be used. There are also digital disruptors like the so-called "Big 5", which are now collecting data on individual behaviour and processing it (data mining): "These big digital players are all outside Europe, so we must ensure that we are able to protect the sovereignty of Member States, but also the healthcare systems themselves. Unfortunately in Europe today we are unable to stand up against these digital challenges. Europe has an essential role to play in putting in place a regulatory framework for that."

Europe also has a role to play in providing the means to meet the challenge: "At European level – as have seen with Airbus and Galileo – we need to provide the resources for health and digitalisation. Even big countries like France and Germany are not able to address the issue of digitalisation on their own. Look at the USA or China. We don't have such resources at Member State level anymore. The response must come from Europe, so that a real overall health and digital plan can be drawn up," concluded Mr Coheur.

The EESC opinion can be found here. There is a list of websites providing supporting background material at the end of the opinion.

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Dis Siri, appelle vite Sara! #hcsmeufr #esante 

From td5f40a4b.emailsys2a.net

Organisée ce jour dans les locaux du Groupe APICIL, à Lyon, la présentation de Sara® est la seconde étape d’une démarche initiée en septembre dernier avec le lancement de BlueHub, la solution inédite qui connecte Siri aux principales solutions domotique existantes, en présence du Business Development Executive Healthcare d’APPLE France.

La rencontre des objets connectés, de l’intelligence artificielle et d’une équipe 24h/24 permet dorénavant de proposer un nouveau type de services, avec une efficacité rarement atteinte auprès des familles. 

Bluelinea a souhaité profiter de cette révolution pour démocratiser ce type de services et faciliter leur déploiement à grande échelle, avec toujours le même objectif : « prendre soin de vos parents, qu’ils soient à domicile ou en EHPAD » ...

France Silver Eco's curator insight, October 11, 10:50 AM

Bluelinea annonce aujourd’hui le lancement de Sara®, le nouveau Service d’Accompagnement, de Réconfort et d’Assistance 24h/24, née du travail d’intégration de la reconnaissance vocale Siri d’Apple au cœur des gammes « Senior Connecté » et « Habitat Connecté ».

Pour les professionnels de santé, l’informatique doit être une solution, pas une contrainte #hcsmeufr #esante 

From www.lesechos.fr

Promulguée en 2016, la loi sur la modernisation du système de santé (dite "Loi Santé" ou encore "Loi Touraine"), modifie le paysage hospitalier français, en particulier avec la constitution des Groupements Hospitaliers de Territoire (GHT), ce qui aura un impact majeur avec des projets numériques structurants, visant à mutualiser les ressources technologiques et administratives.

Cette mutation du milieu médical a un impact positif sur le parcours de soins et améliore durablement la qualité de la prise en charge des patients.

En effet, avec un objectif de décloisonner les différentes composantes de l'écosystème hospitalier à un niveau territorial, cette loi pousse l'utilisation de l'identifiant patient (IPP) pour l'ensemble des applicatifs au sein d'un GHT.


Dès lors que l'on sera en mesure de répondre à cette première problématique, l'utilisation des outils informatiques par les professionnels de santé n'en sera que plus facilitée, tandis que les données saisies pourront être partagées tout en respectant les règles d'identitovigilance.
Il reste néanmoins deux freins à l'adoption généralisée et fluide des nouveaux outils : les supports de saisie et la réactivité face aux imprévus en temps réel ...

France Silver Eco's curator insight, October 11, 10:57 AM

L’hôpital accélère sa révolution numérique : avec la création des GHT, le milieu hospitalier va gagner en efficacité et placer le parcours patient au centre des priorités. L’innovation technologique se met au service de la médecine pour garantir à chacun un accès équitable et éclairé aux progrès de la science.

Roadmap to a Connected Digital Healthcare Future #hcsmeufr #esante #digitalhealth

From www.healthcare-informatics.com

Along almost every dimension, the 2030 healthcare vision is vastly different and improved. Although many components already exist, what’s missing is a cohesive ecosystem.
Florian Morandeau's curator insight, October 11, 6:50 AM

Digital brings more accurate, timely identification and management for a range of health concerns.

Online Patient Engagement Tools Improve Chronic Disease Management

From patientengagementhit.com

Online patient engagement tools helped improve chronic disease management by almost 10% for some conditions.
Richard Platt's curator insight, October 10, 11:38 PM

Online patient engagement tools such as patient portals play a significant role in increasing patient engagement in chronic disease management and preventative care, according to researchers from Kaiser Permanente of Southern California.

online patient engagement tools chronic disease management
Researchers from KPSC conducted a study after implementing the Online Personal Action Plan (oPAP). The oPAP is an extension patient engagement tool to their online patient portal, and helps patients get more information regarding disease prevention, health promotion, and care gaps, closing any disparities in preventative care.  “Even with the efforts of healthcare providers and staff, patients often need help accomplishing their efforts to maintain their health outside the medical office setting, and gaps in care are common,” the research team, led by Shayna L. Henry, PhD, explained.  After examining care gap closure rates between oPAP users and non-users between December 2014 and March 2015, the researchers found that online patient engagement tools like the oPAP can play a significant role in improving the delivery of preventative care and chronic disease management.

Quelle place pour le numérique dans la prévention ?

From travailetqualitedevie.wordpress.com

Les articles abordant l’impact du numérique sur le travail abondent : destruction des emplois par la robotique, transformation des métiers, affaires juridiques liées aux requalifications de contrat de travail concernant Uber, réglementation plus contraignante pour limiter l’expansion d’Airbnb… Je pense qu’il est inutile de lutter contre une tendance de fond qui va se déployer progressivement dans…
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Does Connectivity Help - or Hurt - the Doctor-Patient Relationship? 

From knowledge.wharton.upenn.edu

 

Christian Terwiesch, a Wharton professor of operations, information and decisions, has co-authored two new studies related to technology and health care. The first, which examined the impact of e-visits on primary care, found some surprisingly negative results about connectivity: E-visits can take up more of a physician’s time rather than making patient contacts simpler and more efficient. That has contributed to more physicians feeling overburdened and burnt out, with less ability to take on new patients. The second paper looked at how some of those negative effects could be turned around. Terwiesch sat down with Knowledge@Wharton to talk about these topics, which he describes as a “hot area” that sits at the intersection of medicine and management.

An edited transcript of the conversation follows.

 

Knowledge@Wharton:  Your first paper, written with Lorin M. Hitt and Hessam Bavafa, is titled, “The Impact of E-Visits on Visit Frequencies and Patient Health: Evidence from Primary Care.” You looked at a large population in this study, I think 100,000 or so. You found that electronic visits increase the number of office visits that patients have with physicians, which was maybe the opposite of what was intended. It was thought that e-visits would help to increase efficiency and productivity so that some interactions could be done online, which would save time and money. Give the overall view of the study and what was found?

Christian Terwiesch: Imagine you are my primary care provider and I’m your patient. I want to get in touch with you. I have something that hurts or I’ve got something I want to talk with you about. The old days were very simple. I would just come to your office, make an appointment and see you. That was the traditional way of delivering care. Then with telephones coming in, there was a hope that I could call you. Calling is really a pain because you and I have to be on the line at the same moment. Calling is a synchronous technology.

With email advancing over the last 20, 25 years, this idea that you just email your doctor is very appealing. In fact, many health care systems have gotten to the point where you have an app now to connect to your care team. This connectivity looks really appealing to all of us. There is a little bit of a flaw in that argument in the sense that now that it is easier for me to connect, will I connect more often. We call this the substitution effect. My doctoral student, who’s now a professor at the University of Wisconsin, Hessam Bavafa, and I were working on this and thought maybe these new technologies will substitute for the office visit, in which case the physician becomes more efficient. They can see more patients. They save themselves time.

“Connectivity has this flavor, this potential of making things just more efficient.”

Knowledge@Wharton: That would be a logical assumption.

Terwiesch: It’s very plausible. It’s a substitution effect. You don’t see your travel agent anymore since we have Expedia, right? Connectivity has this flavor, this potential of making things just more efficient. The alternative hypothesis is what we call a gateway hypothesis. I have now an easy gateway into the system, so rather than serving as a substitute, the new connectivity is serving like a gateway, like a portal connecting me to the health care system. Now that the connectivity is so much easier, I start consuming more.

Think about how you’re using the internet. Compare Wikipedia maybe with your good old Encyclopedia Britannica. It’s not just that you have replaced your Britannica, I think most of us are also searching more often. In the case of Wikipedia, that’s no big deal because that thing is automated. But when it comes to our doctors, they’re not. The result that we found was not what we expected, which is now that I have an easy gateway into the system, I’m requiring more hours or more minutes from my care provider than before.

Knowledge@Wharton: That may be good for the patient, but the doctors are not reimbursed from Medicare or Medicaid. Could there be a loss of revenue to the doctor or the practice?

Terwiesch: We have to distinguish between various forms of doctors’ compensation. In the extreme case, we’re all working in the same systems. It’s like a single-payer policy, in which case a doctor is just there to keep you well, so all the costs are going to the same entity. The other extreme is fee for service, where every time that you and I interact there’s some form of a cash register ringing. In the fee-for-service world, this idea that I’m not consuming more care might actually be a good thing for the health care system. In the single-payer model, it’s a different story. Then there are various forms of in-between models where we get compensated as physicians for some things and we don’t provide compensation for physicians for other things. I think right now we have the complexity of these contracts exploding, and it depends a lot on which you doctors you see and what type of contracts they have.

“It’s not that the physicians were playing Minesweeper in the office before. Physicians have always been busy.”

Knowledge@Wharton: In this first paper, it seems the bottom line is that there are unexpected, unintended consequences. Patients are using it more, and not only is that taking up more doctor time, but that leaves less time for doctors to see other patients.

Terwiesch: Absolutely. We really have to remember here that doctors are a scarce resource, especially in some fields such as primary care. When you are taking more time per patient, something else has to yield. It’s not that the physicians were playing Minesweeper in the office before. Physicians have always been busy. I think you see at least two effects. One is that it basically starts to force other people out. Since the physician cannot literally kick out patients from their panels, saying, “Look, I won’t see you anymore,” the price here is paid through access for new patients [as much as a 15% decrease in new patients]. You will see this in many settings where you give practices a call, and they might say, “Sorry, we’re full,” or “Come back in six months.” You say, “In six months, I’m either healthy or dead.” We call this dimension the access.

KNOWLEDGE@WHARTON HIGH SCHOOL

The other effect is on the physician side. Something that we haven’t researched in this paper, but the folks in Wisconsin are doing really interesting research right now, is just the effect of physician burnout because of these emails, these messages. I know this as a professor. It used to be that you see the students during office hours. Now with email, you get these messages 24-7. You see that creep more and more into the personal lives of physicians. We have very good data from studies at the Mayo Clinic that physician burnout stress levels have gone through the roof in the last couple of years. I think they are paying the price by not getting extra compensation, but some are having this expectation that all of that is on top of their regular job.

Knowledge@Wharton: Did this extra time improve patient outcomes?

Terwiesch: We did not find significant effects on the outcome side. If I’m already working at capacity and I give them more work, something has to yield. The weakest spot typically in a health care operation is the new patients. Because they have no connection, the front desk will say, “Sorry, we are full.” The irony is that for the people just studying that practice in isolation, they don’t see these patients because they’re not showing up in any of their medical records. These calls leave no data trail behind. I would argue that these patients who are not getting onto the panel are oftentimes ignored, and they are the ones who, unfortunately, pay the price.

Knowledge@Wharton: Before we get too discouraged about the value of electronic medicine, your second paper raises hope. It looks at how technology can help meet the promise of making things more efficient, more productive and hopefully improve patient outcomes at the same time.

“There’s just lots of noise coming to the desk of the physician.”

Terwiesch: Hopefully. The second paper, with Drs. David Asch and Kevin Volpp at Penn Medical School, starts off with the observation that we’re all talking about connected healthcare (“Technology and Medicine: Reimagining Provider Visits as the New Tertiary Care”). We all like connection. Connected sounds good. But more connection has this ability to make the doctor see patients for things that they wouldn’t see in the past. You know, I had a little boo-boo or I didn’t sleep well. Now the gateway effect is there. There’s just lots of noise coming to the desk of the physician.

Knowledge@Wharton: It’s a hypochondriac’s dream, isn’t it?

Terwiesch: I think it’s only human. We’re talking about our health here, and health is very complex. It’s not getting easier. I think we all want to be connected, but connectivity alone does not solve the problem. I think where we see the opportunity now is pairing that connectivity with some form of an alternative workflow. We need some form of leverage because we are putting more work on the physician.

I think there are really three levers here. The first one is a change in the workforce. It’s empowering non-physicians to do certain things according to rules but without going to the physician. We need to shield that bottleneck. The general lesson in operations management is don’t waste your bottleneck capacity, and the physician is the bottleneck in the health care system.

There is this idea of the patient-centered medical home. It’s no longer just the doctor. Different roles, medication adherence, social worker responsibility. Care is just more complex than what the doctor alone can take care for. If you look at the labor costs for these various positions, a physician, because of the expense of medical education, because it is a very demanding job, is more expensive than a case worker. Why would you have the physician do work that a social case worker could do?

The second lever is some form of automation. I think in this world of connected devices, we’re connected to our health care system whether we want it or not. The technology is there that the health care system can read my vitals from my scale to my toilet, from my blood pressure to my heart rate. Some of that is already there, but it’s a matter of years, not decades, until we are so connected that all of this data is there. Some algorithm has to form some triage there to sort out what is clinically relevant and what can we let go.

Imagine you have a change in heart rate. That could be a result of a fluid consumption if you might have just gone to a party, gone to bed, you’ve been drinking too much last night and your body shows some abnormal behavior. A very simple algorithm that observes you every morning over the last two years will pick up very quickly that there’s something abnormal. The red light goes on. Should we just automatically call 911 and get an ambulance? Maybe not. Should it go to the physician? Maybe not.

Knowledge@Wharton: Tell us about the third lever?

Terwiesch: We have more connectivity with more things coming in, and we can bring them to the doctor. That doesn’t work, so we need a new workforce. We can use machine learning, or artificial intelligence, to avoid them. In one way or the other, we have to use the patient more. We have to do self-service. The convenience you have gotten through technology is just not a cheap replacement of, but it’s just a way-better solution. If we can think about what we can do through technology, where we take things that right now are requiring capacity from the doctor’s office, what can we do to have self-service kick in for that?

Knowledge@Wharton: What would be some good examples of that?

Christian Terwiesch: If you think about your last medical office visit, what comes to mind for most of us is you get greeted at the office and you get a pile of paperwork. You’re entering your medical history, filling out some forms, and you think, “Why can I check in online for a flight but not at my physician’s office?” A lot of these things can be done by the patient already at home, electronically. Nobody has to type these things.

I think the next level up is when you think about medication compliance and medication administration. We’ve done some time and motion studies where we’ve spent time literally stop-watching what happens in the doctor’s office. It’s a huge chunk of time in primary care. Kevin Volpp has done some really cool experiments around engaging patients by playing some form of lottery games, giving them small financial incentives. You can get patients to take a more active role in their meds, and you can hopefully reach out to their family and friends and have them be the cheerleader. Because the physician being the cheerleader for you and me taking our meds is a very expensive way of doing things.

Knowledge@Wharton: Tell us about that lottery game — to encourage compliance with meds?

Terwiesch: Again, I’m referring here to great work that my friend and colleague, Kevin Volpp, has done. He has done these studies in a variety of settings where he looked at weight loss, smoking cessation and medication adherence. Medication adherence is something where we have looked together, also with David Asch, on what happens when people get discharged from the hospital after cardiac problems.

More often than not, it was kind of adherence rates that are well down into the 50 percentages. Even people who have had severe cardiac problems would start falling into bad habits six months after discharge. What we did in that study was use pill bottles that are connected to the internet, where the research team can see whether these pill bottles have been opened or not. They take the opening process as a proxy for whether the patient took the meds or not. If we see that you haven’t taken your meds for a couple of days, our red light goes on and we start an intervention.

There are two types of interventions we have played around with. The first one is a lottery, where every week you are eligible for a small lottery. This is not a lottery that will win you a beach house or some multimillion-dollars gift, but a $10, $15 lottery for the week. You only get into that kind of draw if you have been compliant every day. That’s a way of getting patients engaged. The money is small, and if you think about the downstream consequences of noncompliance, they oftentimes can be just so much more expensive.

The other is we played with your social network. We had you designate a friend or family member you felt would be a good cheerleader for you. Rather than alerting you, “Hey, you haven’t taken your meds the last two days,” I’m going to alert your best friend from college, your adult daughter, somebody else. They’re in a much better position to reach you and have an influence on you than the physician ever could be, not to mention, that is a much cheaper process. I think of all of those as forms of self-servicing the patient. If you look at so many other industries, self-service is not just an inconvenient, cheap replacement. Most service experiences I can think of, if you empower me to self-service, I’m actually happier than I was before. It puts you in control.

Knowledge@Wharton: What stage of testing are you in with these levers?

Terwiesch: Kevin Volpp has done an amazing set of experiments over the last couple of years, many of them published in JAMA. It has shown very great efficacy, especially of these lotteries. We have done experiments with the medical adherence, and we see very substantial adherence improvements. This is stuff that is happening right here at Penn, at the intersection between the medical school and the Wharton School. I think that’s a very hot area and something we should be very proud of here.

Knowledge@Wharton: What’s the next step for your research?

Terwiesch: I want to understand this connected user experience more. I’ve been saying so many bad things about the increased connectivity that people might say, “There’s no hope for connected health care.” I think there’s just this valley we have to march through, that when you move from disconnected to connected, you start learning a lot of new things that you didn’t know before.

Initially, it’s going to be painful because you’ll learn a lot of things that before you could just ignore. But I think the long run is going to get us to a world where we have more connections rather than fewer. The technology’s getting cheaper as we speak. The algorithms, the AI is getting better and better, so we will get there eventually. I’m working on a project at the Mack Institute of Innovation Management with my colleague, professor Nicolaj Siggelkow, on creating connected user experiences. How can we use connectivity so that it’s not a burden for the enterprise but it really leads to great user experiences and potentially lower fulfillment costs?

 

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Une santé numérique éthique et humaine : est-ce possible ?

From www.sciencesetavenir.fr

Lors du Forum SRS, Sciences, Recherche et Société, organisé par La Recherche et Sciences et Avenir, des experts ont discuté de la meilleure manière d'utiliser les nouvelles technologies connectées dans la santé.
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The Imminent Digital Health Revolution

From www.electronicdesign.com

Preventative and therapeutic care will be driven by predictive analytics, but engineers must first transform the complex data into beneficial insights.
Florian Morandeau's curator insight, October 5, 2:33 AM

Digital health: The challenges of transforming complex data into beneficial insights.

Art Jones's curator insight, October 6, 2:24 PM

The Future of Healthcare is the aggregation of big data, the blockchain, artificial intelligence, machine learning, mobile devices and of course, in the near term, humans have a roll in the process too.

Survey: 77 percent of Medicare members have used digital health tools

From www.mobihealthnews.com

According to a new survey of 500 Medicare plan members, 77 percent of Medicare beneficiaries have used digital health tools. Yet just nine percent of respondents indicated that their health plan integrated data from those tools. Looking specifically at the 70 percent of beneficiaries with one or more chronic conditions, just eight percent said digital health tool data was used by their health plan. 
Florian Morandeau's curator insight, October 5, 2:37 AM

Blood pressure monitors are the top used IoMT devices.

How the FDA Should Regulate Medical AI Systems

From blogs.wsj.com

The FDA will face new challenges in vetting the efficacy of artificial intelligence, says WSJ Health Expert John Sotos.
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