With one half of health industry executives saying they are concerned about how to integrate social media data into their business strategy there is a recognition social media presents a significant industry challenge.
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The literature on implementing Electronic Health Records (EHR) in hospitals is very diverse. The objective of this study is to create an overview of the existing literature on EHR implementation in hospitals and to identify generally applicable findings and lessons for implementer.
A systematic literature review of empirical research on EHR implementation was conducted. Databases used included Web of Knowledge, EBSCO, and Cochrane Library. Relevant references in the selected articles were also analysed. Search terms included Electronic Health Record (and synonyms), implementation, and hospital (and synonyms). Articles had to meet the following requirements: written in English, full text available online, based on primary empirical data, focused on hospital-wide EHR implementation, and satisfying established quality criteria.
Of the 364 initially identified articles, this study analyses the 21 articles that met the requirements. From these articles, 19 interventions were identified that are generally applicable and these were placed in a framework consisting of the following three interacting dimensions: EHR context, EHR content, and EHR implementation process.
Although EHR systems are anticipated as having positive effects on the performance of hospitals, their implementation is a complex undertaking. This systematic review reveals reasons for this complexity and presents a framework of 19 interventions that can help overcome typical problems in EHR implementation. This framework can function as a reference for implementer in developing effective EHR implementation strategies for hospitals.
Via Technical Dr. Inc., Lionel Reichardt / le Pharmageek
rob halkes's insight:
"Implementation" a continuous concern when in healthcare ;-)
Certainly when it comes to electroniuc health care records and/or personal records.. See the literature review here!
Even though the concept of telemedicine has been floating around for decades, it is only really beginning to soar as of late. Why, if we had this revolutionary concept right underneath our noses, are we just beginning to utilize it? There are many reasons for this, some of which include:
Well that’s our look at why telemedicine was waiting in the wings until now! Thanks1
rob halkes's insight:
Indeed, a good summary of the objections to a further growth of #ehealth and #telemedicine. I believe we must add: lack of integrated cooperation between different stakeholders to the same patient pathway in healthcare. So, much leaves to be done still! See this introduction to ehealth http://bit.ly/2aeJg31
Editorial from BMJ
Two articles1 ,2 describe the use of social media to describe or potentiate healthcare quality improvement. Taken together, these articles point to an exciting—but still nascent—trend. We hope that these two pilot studies will be taken as a call to future research rather than as definitive reports.
The first article1 describes the proportion of emergency department (ED) patients who consent for researchers to download their Facebook and Twitter data. The novelty of this study lies in its underlying premise: accessing patients’ social media data could, in theory, permit better awareness of patients’ health status and risks, and thereby permit real-time interventions and improved patient engagement. To our knowledge, this study is the first to show the acceptability, feasibility and limitations of accessing patients’ social media data. It thereby gives hope that incorporating social feeds into healthcare may be possible.[...]
Finally, both articles touch on—but do not provide answers to—the spectre of privacy. In the first paper, among the 50% willing to engage in discussion, privacy was the primary reason for people refusing to share their data. The authors note that in general, public supports purpose of using social media data for health research, accepting it without consent (compared with their lack of support for marketing research, done with their consent)—but this paper suggests attitudes change when it's an individual's data that's being requested, during that individual's emergency. These findings are similar to those of others’ findings regarding patients’ privacy preferences for electronic health information.13 [...]
All of these limitations aside, we are enthused by these papers. Together, they help lay the foundation for further efforts integrating social media into electronic health record (EHR) and healthcare... See it in pdf
rob halkes's insight:
Good to see good BMJ research on the use of social media and healthcare qwuality improvement. No easy connections between the two, but prmising developments! Privacy is indeed a case in point! Authors Megan Ranney at @meganranney and Nicholas Genes at @nickgene warn for high expectations but do dream of options and possibilities. Gr8!
Dignity Health, announced results from a randomized controlled study which demonstrated that the use of digital health technology improved asthma control. The study, “Effectiveness of Population Health Management Using the Propeller Health Asthma Platform: A Randomized Clinical Trial,” was recently published in the Journal of Allergy and Clinical Immunology: In Practice.
The Propeller Health Asthma Platform utilizes sensors, mobile applications, and analytics to monitor short-acting β-agonist (SABA) and inhaled corticosteroid use in real-time. The platform provides detailed information about patterns of medication use and notifications about patients with worsening asthma control.
“The research demonstrates that the benefits of telehealth go beyond monitoring medication adherence, but can also identify patterns of risk and impairment. This additional information may allow more timely interventions and enhanced asthma management,” said Dr. Rajan Merchant, the principal study investigator and physician at Dignity Health’s Woodland Clinic Medical Group. “Although additional study efforts are needed, digital health is promising to help improve care and asthma control.”
Currently, more than 40 percent of both adults and children in the U.S. report uncontrolled asthma, according to recent studies. Current guidelines recommend monitoring of SABA use and assessment of asthma control. Electronic monitoring of SABA use provides an indication of poor asthma control.
More than 495 adults and children enrolled in this study. The results found that the total amount of SABA use, and the total number of days when SABA was needed, was lower in the group using the Propeller Health Asthma Platform compared to the patients receiving routine care. Furthermore, a significantly greater increase in the Asthma Control Test was demonstrated in adults with uncontrolled asthma in the intervention group compared to adults with uncontrolled asthma under routine care.
rob halkes's insight:
ANother example of telemedicine working to results. There is indeed more than technology needed, like an organised integrated care path. See here!
Conclusions: A telemedicine-based symptom reporting program facilitated early treatment of symptoms and improved lung function and functional status.
Background: Patients with chronic obstructive pulmonary disease (COPD) may not recognize worsening symptoms that require intensification of therapy. They may also be reluctant to contact a healthcare provider for minor worsening of symptoms. A telemedicine application for daily symptom reporting may reduce these barriers and improve patient outcomes.
Results: Eighty-six patients were screened; 79 met entry criteria and were randomized (intervention group, n=39; control group, n=40). Twelve patients submitted five or fewer symptom reports (5 intervention; 7 control) and were excluded from the analysis. Daily peak flow and dyspnea scores improved only in the intervention group. There were no differences in hospitalization and mortality rates between groups. No serious adverse events were reported.
rob halkes's insight:
Confirming expectations about eHealth effectiveness is needed. Implementation based on these insights is crucial. EHealth applications intervene in delivery processes and make education of participants, professionals and care givers, necessary.
See here: eHealth the introduction.
The same forces that have made instant messaging and video calls part of daily life for many Americans are now shaking up basic medical care.
She sat with her laptop on her living room couch, went online and requested a virtual consultation. She typed in her symptoms and credit card number, and within half an hour, a doctor appeared on her screen via Skype. He looked her over, asked some questions and agreed she had sinusitis. In minutes, Ms. DeVisser, a stay-at-home mother, had an antibiotics prescription called in to her pharmacy.
The same forces that have made instant messaging and video calls part of daily life for many Americans are now shaking up basic medical care. Health systems and insurers are rushing to offer video consultations for routine ailments, convinced they will save money and relieve pressure on overextended primary care systems in cities and rural areas alike. And more people like Ms. DeVisser, fluent in Skype and FaceTime and eager for cheaper, more convenient medical care, are trying them out [..]
But telemedicine is facing pushback from some more traditional corners of the medical world. Medicare, which often sets the precedent for other insurers, strictly limits reimbursement for telemedicine services out of concern that expanding coverage would increase, not reduce, costs. Some doctors assert that hands-on exams are more effective and warn that the potential for misdiagnoses via video is great [..].
While telemedicine consultations have been around for decades, they have mostly connected specialists with patients in remote areas, who almost always had to visit a clinic or hospital for the videoconference. The difference now is that patients can be wherever they want and use their own smartphones or tablets for the visits, which are trending toward more basic care.[..]
Advocates say virtual visits for basic care could reduce costs over the long term. It is cheaper to operate telemedicine services than brick-and-mortar offices, allowing companies to charge as little as $40 or $50 for consultations — less than for visits to emergency rooms, urgent care centers and doctors’ offices. They also say that by letting people talk to a doctor whenever they need to, from home or work, virtual visits make for more satisfied and potentially healthier patients than traditional appointments that are available only at certain times.[..]
When the doctor appeared on her screen, she told him her symptoms and, holding her iPad close to her face, showed him her painful tooth and the swelling in her jaw.
“I was in so much pain, I didn’t care that it was weird,” Ms. Sickmeier said. “He got right to the point, which was what I wanted. He prescribed antibiotics and called them into an all-night pharmacy about 20 minutes away.”
Washington State gave a victory to the industry in April when Gov. Jay Inslee, a Democrat, signed legislation requiring insurers to cover a range of telemedicine services if they already cover those services when provided in person. But the new law, which made Washington the 24th state to ensure reimbursement for some telemedicine services, does not cover virtual urgent care outside a medical facility.
Still, the law “opens the doors with a lot of our payers,” said Matt Levi, CHI Franciscan Health’s director of virtual health services. He added that some insurers, like Molina Healthcare of Washington, the state’s largest Medicaid plan, were starting to cover virtual urgent care, though the law does not require it. [...]
Some large insurers are starting to pay, too. UnitedHealthcare, the nation’s largest insurer, announced in April that it would cover virtual visits for most of its 26 million commercial members by next year, citing the shortage of primary care doctors and the cost of less than $50 per virtual visit.[...]
Virtual urgent care visits are undoubtedly less expensive than trips to the emergency room, said Dr. Ateev Mehrotra, a professor of health policy at Harvard Medical School, who has studied telemedicine.[..]
CHI Franciscan’s virtual urgent care program contracts with Carena, a private company in Seattle that employs 17 physicians and nurse practitioners to do virtual consultations in 11 states. Among CHI Franciscan’s patients, the most frequent users are women ages 25 to 55, and the most typical diagnoses are bladder infections, upper respiratory tract infections and pinkeye.
Users are prescribed medication about 40 percent of the time, said Beth Bacon, the company’s vice president for consumer affairs. Most visits take place on weekends or between 5 p.m. and 8 a.m., she said, when doctors’ offices are closed. Like other virtual urgent care programs, CHI Franciscan’s emphasizes that it is not for medical emergencies, advising customers on its website to “call 911 or proceed to the nearest emergency room” if they have chest pain, difficulty breathing or other potentially life-threatening symptoms.Continue reading the main story
rob halkes's insight:
Early applications of telemedicine / ehealth will struggle with experimental features of it. The benefits and profits to all stakeholder indicate the necessity of sustained effort. Along with necessary changes in healthcare as it is now, there is an effective outcome to be expected.
Rely on Curely for everyday health concerns Watch Video HOW IT WORKS Curely brings board-certified doctors around the world to your fingertips. CHOOSE YOUR DOCTOR Browse through a list of board-certified doctors and select your doctor by specialty, price, and language. DISCUSS YOUR CONCERNS WITH YOUR DOCTOR Chat with a doctor immediately or send a …
rob halkes's insight:
"Curely" A doctor in your phone, on line. Again a new platform for distant help and support. I would be very much interested in evaluation data by patients ;-)
The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings.
rob halkes's insight:
Mind you: the evidence says about telemedicine: "Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings." So ehealth is on its way of fundamental recognition!
Want to know what it is: See "What is ehealth?"
Wearables are anything but sensible, from first hand observation they are somewhat silly, as they are trying to solve a problem that can be solved by a myriad of simpler and more passive mechanism.
If you were at CES, you could not have missed a new category of computing called "wearables." This category of devices can be described as the FitBit gone mad. Wearables currently come in three main categories: health trackers, watches and glasses. In each of these categories some if not all devices are pivoting to solving the world's biggest health problems.
Almost daily, I see a new wearable device launched, and while they all are minimally viable products, they continually get sillier and sillier. We are seeing everything from wearable necklaces (like necklaces were never wearable) earrings, shoes, clothing and many other bodily accruements being outfitted with small computers/biosensors, low voltage needs and high connectivity. Like clockwork, every new device no matter how silly, calls out to the world with press releases, tweets, YouTube videos and multiple pounds of the manufacturing firm's proverbial digital chest reckoning how disruptive some new wearable product is.
My observation is that we have bastardized the word disruption. Most wearables are disturbing mankind under the once well-intended charter of disruption.
While a minority of humans continue to wear these devices past the first few months of purchase, most folks (like myself) stop wearing after the nostalgia has worn off. I gave up my FitBit after about six months, my pebble watch in about six days and my Google GLASS, well I got over that bad boy in about six hours. I got over them the same way I got over my first CASIO watch, which doubled as a calculator in high school; said watch plus calculator was disturbing my life. Disruption does not have to disturb.
Good disruption is change without disturbance.
The hypothesis is simple, wearing something on my body that is not confortable, fashionable and delivering more value than it disturbs me is not a sustainable value proposition. So the big question is what will become of wearables? Clearly the movement of computing to the edge of the network will continue, and the connecting of things/biosensors that are not computers (Internet of Things) will continue. Wearables currently position themselves as trying to solve health's biggest problems. [..]
Read the full article!
rob halkes's insight:
Reflective critique is always good. But I guess the way forward in health care to the triple aim (better care, better outcomes , less costs) is not as simple as to claim that disruption by wearables might go on without disturbance.
In healthcare "digital', e-health, telemedicine and sensores will have to large an impact on the way health care is organized and paid. My claim? Disruption will not succeed without disturbance!
LinkedIn has become a staple social media outlet for professionals across the board, and now more than ever, people are actively using this platform to share information. One and a half million LinkedIn members are sharing content and sixty-five percent of users have increased their consumption over the past year. This drastic increase is now being called “the content revolution,” and is a phenomenon that should not go unnoticed by healthcare professionals.
rob halkes's insight:
Is my own experience as well..
Madison, Wisconsin-based Propeller Health, formerly known as Asthmapolis, has raised $14.5 million in a round of funding led by Safeguard Scientifics with participation from return backer The Social+Capital Partnership. (..)
The smart inhaler company’s devices and companion apps offer geographic mapping of inhaler use and asthma triggers as well as adherence tracking and early warning alerts for COPD patients.
“The funding supports the mission we are already on: to bring sensors to the full variety of the inhaled medications that are used for chronic respiratory disease,” Propeller Health CEO David Van Sickle told MobiHealthNews in an interview. “We are already well down that path… but the respiratory pipeline is fairly active. We are seeing new medications, therapies, and form factors.”
In May Propeller received FDA clearance for its COPD offering. The new platform aims to help users prevent so-called “asthma attacks” or similar lung inflammation symptoms caused by COPD. The Propeller Metered-Dose Inhaler measures a patient’s use of their rescue inhaler. That data is automatically compared to a patient’s baseline and to general clinical guidelines, and the app can alert care teams if an attack seems likely.
“In addition software development, as we take on more COPD programs, we have a broad spectrum of demographics that we have to cover with our products and services,” Van Sickle said. “So we are building out teams to support the usability and experience of not only kids with respiratory disease but elderly folks with respiratory disease, caregivers, new enterprise teams for care managers which are on their own evolving with the times and new healthcare arrangements.”(..)
Propeller is seeing a lot of interest in COPD programs, Van Sickle said, partly driven by the market forces in healthcare incentivizing providers to reduce readmissions for COPD patients in particular. (..)
rob halkes's insight:
Chronic diseases: the floor for researching these key questions:
By Marie Ennis-O'Connor @JBBC
Twitter is a conversation, and just as you observe conversation etiquette in real life, when it comes to healthcare tweeting there are unwritten rules, too.
If you are new to Twitter becoming familiar with these rules will ease your transition into its culture; if you are already a seasoned tweeter, take this opportunity to see how you score on your Twitter etiquette.
Being courteous to those who follow you is the first rule of Twitter etiquette. Apologize if you make a mistake and never get drawn into a public argument. If someone wants to argue with you on Twitter either ignore them or if they have a genuine grievance take it offline.
Twitter is an excellent way to allow your personality to shine through your tweets, but you need to strike the right balance between the personal and professional. The standards expected of health care professionals do not change because you are communicating through social media. Posting inappropriate photos and using explicit language is definitely not on. Be professional at all times; avoid flippancy or irreverence which may be misconstrued.
As much as possible respond to those followers who engage with you and thank those who "Retweet"(RT) your updates in a timely manner. Use their real name whenever you can.
You are under no obligation to follow every person who follows you. Following a large number of people indiscrminately diminishes your credibiltiy. Be selective and only follow those you genuinely want to engage with and who add value to your Twitter feed. Similarly not everyone will want to follow you and that's ok. Never call someone out for not following you. Finally don't be the kind of follower who follows someone in order to get them to follow back, and then immediately unfollows.
Whatever you post on your Twitter timeline is visible to everyone (whether they're following you or not). If you are engaged in a private conversation with someone on Twitter, use the "Direct Message" (DM) function to communicate. If you want to get in touch with someone about a business opportunity, contact him or her by email.
While Twitter is a good place to promote your healthcare expertise or service, too much self-promotion will lose you followers. It’s ok to share your own content, so long as you balance it out by sharing content from others too. Some social media experts suggest following the 80/20 rule - posting content for your followers 80% of the time and for yourself 20% of the time - but there are no hard and fast rules on this. In the same vein constantly retweeting people who praise you makes you look boastful and self-serving.
Be transparent. If you tweet an idea or opinion that originated with another Twitter user, give them credit. Clicking "Retweet" (RT) on a user’s Twitter update allows you to share it with your followers. Alternatively you can manually retweet the post (add "RT" or "via" followed by @ the user’s handle) and add your own comment or insight. If you abbreviate the original tweet add "Modified Tweet" (MT). Adding HT (meaning "Hat Tip") to acknowledge a user who has pointed you in the direction of something interesting is considered polite.
Shortening long links in your tweets makes for a more streamlined experience for you and your followers. Use a url shortener like bit.ly which also gives you useful realtime information about who's clicking your Bitlink.
Do not use automated tweets to thank new followers when they follow you. You may do it with the best of intentions but an auto-DM (automatic direct message) is often viewed as spam. Never auto-DM a link to your website or service.
It’s ok to ask for a "Retweet" (RT) once in a while, but constantly seeking RTs from your followers is annoying for them.
A hashtag is a popular way of creating and monitoring a conversation around a particular health related topic. To create a hashtag, simply place the # symbol before a word but don't over do it. Placing too many hashtags in your tweet is visually unappealing and may make your tweet look like spam.
If you do a lot of catching up on blogs and other online content first thing in the morning, it is easy to flood your Twitter feed with multiple links. Using a scheduling tool will help you manage a steady trickle of valuable tweets throughout the day, rather than deluging your followers with a downpour all at the same time. If you're going to be live-tweeting or taking part in a healthcare chat it’s polite to let your followers know that you will be tweeting more than usual. Stick to your allotted 140 characters; spreading your thoughts over multiple tweets can be off putting.
When you share a link to an article, go beyond the headline to add your insight. Contribute your expertise to one of the many health related Twitter chats. You will find a full list of health hashtags via Symplur's Hashtag Project.
None of the above rules are mandatory and you will likely see them flouted every day on Twitter. However by following these unspoken rules of Twitter etiquette you are on the right path to attract new followers, engage more meaningfully with your existing followers and enrich the online healthcare conversation.
rob halkes's insight:
Great guidelines for tweeting in health care!
One misconception clinicians and policy-makers have about a Personal Health Record is that it is a luxury available only to a wealthier minority and that, as a result, anyone promoting it is somehow turning their back on a whole segment of the population. The desire to improve access is one we at PKB fully support; we therefore strongly believe that this interpretation of PHRs is outdated and bad for patients. This is why the UK government, for example, has a Digital First strategy for the NHS. Digital services should be offered as the default, rather than delaying because of fears over access. In fact, if we look at the numbers, access is at remarkable levels already.
A study recently released by Ofcom, as part of an effort to “scorecard” internet and mobile infrastructure, access and speed in the UK, found the UK is a leader. It scores a whopping 81% of individuals accessing the internet at least once a week.
rob halkes's insight:
Yes, we are definitively connected with one another no excuse anymore for reluctance on ehealth ;-)
Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet
Background: In low/middle income countries like India, diabetes is prevalent and health care access limited. Most adults have a mobile phone, creating potential for mHealth interventions to improve public health. To examine the feasibility and initial evidence of effectiveness of mDiabetes, a text messaging program to improve diabetes risk behaviors, a global nonprofit organization (Arogya World) implemented mDiabetes among one million Indian adults.
Objective: A prospective, parallel cohort design was applied to examine whether mDiabetes improved fruit, vegetable, and fat intakes and exercise.
Methods: Intervention participants were randomly selected from the one million Nokia subscribers who elected to opt in to mDiabetes. Control group participants were randomly selected from non-Nokia mobile phone subscribers. mDiabetes participants received 56 text messages in their choice of 12 languages over 6 months; control participants received no contact. Messages were designed to motivate improvement in diabetes risk behaviors and increase awareness about the causes and complications of diabetes. Participant health behaviors (exercise and fruit, vegetable, and fat intake) were assessed between 2012 and 2013 via telephone surveys by blinded assessors at baseline and 6 months later. Data were cleaned and analyzed in 2014 and 2015.
Results: 982 participants in the intervention group and 943 in the control group consented to take the phone survey at baselne. At the end of the 6-month period, 611 (62.22%) in the intervention and 632 (67.02%) in the control group completed the follow-up telephone survey. Participants receiving texts demonstrated greater improvement in a health behavior composite score over 6 months, compared with those who received no messages F(1, 1238) = 30.181, P<.001, 95% CI, 0.251-0.531. Fewer intervention participants demonstrated health behavior decline compared with controls. Improved fruit, vegetable, and fat consumption (P<.01) but not exercise were observed in those receiving messages, as compared with controls.
Conclusions: A text messaging intervention was feasible and showed initial evidence of effectiveness in improving diabetes-related health behaviors, demonstrating the potential to facilitate population-level behavior change in a low/middle income country.
Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN): 12615000423516; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367946&isReview=true (Archived by WebCite at http://www.webcitation.org/6j5ptaJgF)J Med Internet Res 2016;18(8):e207
rob halkes's insight:
Little steps in applying ehealth and mhealth facilitate health improvement. So there is ample opportunity to create a roadmap to develop further applications. It will also allow for initiatives to create collaboration and as a next step sustainable partnerships between the industry and healthcare providers. See our thought lab for ehealth here
For a growing number of people, the main way to communicate with people, both personally and professionally, is through their smartphones. While digital communication has become widely accepted, there is one place where its adoption is lagging: health care. U.S. News and World Report points to a Nielsen survey that shows that the vast majority of medical professionals in the United States do not use e-mail or text messages to communicate with their patients.
Physicians welcome new forms of technology in their practices, and smartphones seem like a logical way to improve patient engagement, patient adherence, and patient empowerment. So why don’t more doctors text or e-mail their patients? The fact of the matter is that the reluctance of physicians to embrace digital communications with their patients has little to do with technology.
Doctors want to offer the best possible care for their patients but, like anyone who provides a service, they also want to be paid for it. Doctors can easily submit a claim for an office visit or a medical procedure but, as U.S. News explains, the insurance system is not currently set up to reimburse a doctor’s digital communication with his or her patients. But that is starting to change, healthcare reform has shifted insurance models toward compensating doctors for the quality of the care, as well as patient outcomes. But insurers still need to formally recognize these communication changes.
Regulatory restrictions are another barrier to doctor/patient digital communication. Under the federal Health Insurance Portability and Accountability Act, healthcare providers must take steps to ensure the privacy of patient information. Some forms of digital communication are just not secure enough to meet HIPAA requirements. With some effort, a physician can find a telecommunications and software services that meet federal security requirements, but the burden is on the physician to find these providers.
Even though digital communication with patients has a long way to go, changes are on the way. Demand is driving the IT sector to develop new technological solutions. “The generation of young and digitally native doctors will help expedite this process,” U.S. News says.
While digital communication has become widely accepted, there is one place where its adoption is lagging: health care.
rob halkes's insight:
The digital future of care seems to be self evident, but innovators often run hard to the walls of everyday practice. Innovation in care can only come about if the three basic perspectives in care: medical, patient and organizational/financial will be taken into account. See here: http://bit.ly/businessofhealthcare
HIMSS study shows telemedicine software solutions poised for growth in 2016
Originally posted on Nov, 2015
Although organizations in the United States are still trying to optimize the use of current telehealth solutions, telehealth is undoubtedly poised for continued growth in the U.S. (and many other countries as well). Telemedicine is gaining momentum as it has proven to increase access to care and reduce costs via teleconsultations and remote patient monitoring. U.S. consumers are beginning to use wearable devices to track and collect their personal health data. Over time, we will see more of a willingness to share that data with healthcare providers and intermediaries.
The Healthcare Information and Management Systems Society (“HIMSS”) conducted a survey on telemedicine adoption in the United States. The survey polled 276 healthcare decision makers and physician executives. Brendan FitzGerald, research director at HIMSS Analytics, discussed the results with some of us last week. Here are some highlights of the survey’s findings, of those engaged in telemedicine:
The HIMSS Analytics survey can be found here.
You can contact ABISA, a consultancy specializing in solo and small group practice management by visiting them at ABISALLC.com.
Link to original post
rob halkes's insight:
Although different names are given to eHealth, like telemedicine is one of them, Its growth in healthcare is unavoidable.
Conclusions: Caregivers of children with special healthcare needs have notable levels of psychosocial challenges and those challenges are associated with their e-health resource seeking. Although e-health interventions, including ones that focus on child health education and caregiver support, may be the future of healthcare, a concerted effort is needed to educate caregivers about the benefits of e-health.
Objectives: In this study, we explored the relationships between the psychosocial health of caregivers of children with special healthcare needs and their e-health use. Additionally, the analysis examined moderating effects of a caregiver's perceptions of e-health and his or her e-health literacy on the associations among four domains of psychosocial health and e-health use.
Materials and Methods: To date, 313 caregivers of children, 12–18 years of age, with special healthcare needs have been recruited. Covariate-adjusted multivariable regressions determined associations between psychosocial health domains of caregivers and e-health use. E-health literacy and perceptions of e-health were further tested as moderators of the relationship between psychosocial health and e-health use.
Results: Among the caregiver population, 31% had problems with social functioning, 36.1% with communication, 43.3% with family relationships, and 46.3% with worrying for their child. After adjusting for demographic variables, e-health use was associated with poorer levels of social functioning, communication, worry, and family relationship.
rob halkes's insight:
Perceptions of eHealth of caregivers, in this case: parents, influence its appreciation and use. Indeed as the researchers conclude: a concerted effort is needed to educate caregivers before its use, and based on our own experience to make the provision of ehealth ingrated in the care delivery process and to implement the needed accommodation in the organisation of healthcare.
Forty-one percent of consumers have never heard of telemedicine, according to a new survey of 1,200 consumers conducted by Survey Sampling International on behalf of HealthMine. That number goes down for millennials, just 30 percent of whom say they haven’t heard of telemedicine, but it goes up for the 45 to 64 age group, 46 percent of whom hadn’t heard of telemedicine.
HealthMine is a consumer health engagement company, and as such has a stake in gauging consumer awareness of health technology trends.
“Telemedicine has the potential to deliver convenient and affordable basic healthcare to people of all ages,” Bryce Williams, CEO and President of HealthMine said in a statement. “Wellness programs can be the place where consumers are educated on the best way to access healthcare services, whether it be through a doctor’s office, emergency room, urgent care center, or telemedicine visit. Plus, telehealth is evolving to more than telephone visits. Soon, your smartphone will be a stethoscope and more.”
In the survey consumers were asked whether they would use telemedicine if it was offered by their physician as an alternative to traditional doctor visits, and whether they understood when it was best to use telemedicine. For the second question, “I’ve never heard of telemedicine” was included as a response option.
Overall, 45 percent of respondents said they would use telemedicine if it was offered, 16 percent said they wouldn’t, and 39 percent weren’t sure. The number who said they would use telemedicine rose to 58 percent for millennials (25 to 34-year-olds) and dropped to 37 percent for 55 to 64-year-olds. However the difference was mostly in how many were unsure — the portion of each group that answered “no” was 15 percent for millennials, 17 percent for seniors, and 16 percent for all age groups in between.
Forty-three percent of total respondents said they knew when it was best to use telemedicine, 16 percent said they didn’t, and 41 percent said they hadn’t heard of telemedicine. Fifty-two percent of millennials and 46 percent of 35 to 44-year-olds felt they knew when to use telemedicine compared to 38 percent of 55 to 64-year-olds and just 34 percent of 45 to 54-year-olds.
Earlier this month, a 500-person survey from TechnologyAdvice found that some 35 percent of consumers said they would likely choose a virtual visit over an in-person one. The survey also found that 56 percent of respondents would be somewhat or very uncomfortable conducting a doctor visit using a telemedicine offering. On the other hand, 75 percent of people said they would not trust a diagnosis that a doctor made over a video visit, or would trust it less than if they met with a doctor in person.
rob halkes's insight:
Very inspiring data found in asking consumers whether they knew of "telemedicine"! Disappointing numbers indeed. BUT: the positive sight is that doctors and health insitutions now still have the opportunity to introduce it the right way!
Health Hashtags Research - Can We Make It Work?
People deserve access to safe, reliable health information online. Doctors have an ethical obligation to help make the internet easier and safer. Will health hashtags help or not?
Analyzing 531,765 tweets from over 70,000 users through December 2014, we found that CTO use is increasing. 93% still come from tags with active chats. We didn’t do any formal statistical analysis, but it’s interesting to see how each tag has different stakeholders using them.
At the meeting, ASCO attendees from all backgrounds expressed interest and came to the poster: patients, advocacy organizations, doctors, industry. Beyond the scope of the study, I learned more from discussion with Symplur: as of early May, 62% of NCCN-designated cancer centers have used CTO tags at least 25 times. The five biggest users: Dana-Farber Cancer Institute, MD Anderson Cancer Center, Lurie Comprehensive Cancer Center, Memorial Sloan-Kettering Cancer Center, and UCSF Medical Center.
Despite the great response, we need more research on whether hashtags help. Originally, I focused on creating meaning and community-building by patients and advocates. Collaboration with doctors like Deanna Attai has worked great for #bcsm, but #pancsm was started by doctors. It has been active and useful, just different. What will work best? Read on here: Symplur
rob halkes's insight:
A very inspiring and intriguing initiative at the same time. Patients need to be informed about information concerning their diseases and how to cope with it. Still, how can we help them without bias to get the right meaning for them. We do not want to patronize patients, but it is not wrong to know that they might need support. doctors might be the first trusted source to turn too.
Let's be honest the speed of research and new insights is one of the trends that disrupt our routines of professional work.
This is to be found in this initiative by Matthew Katz. @subatomicdoc
rob halkes's insight:
How fast is heathcare realy changed?
Editor's note: Matt Turck is a managing director of FirstMark Capital. The he emerging Internet of Things — essentially, the world of physical devices connected to the network/Internet, from your Fitbit or Nest to industrial machines — is experiencing a burst of activity and creativity that is getting entrepreneurs, VCs and the press equally excited.
The chart [..] is an attempt at making sense of this frenetic activity. From bottom to top, I see three broad areas – building blocks, verticals and horizontals:
The concept of the Internet of Things is not new (the term itself was coined in 1999), but it is now in the process of becoming a reality thanks to the confluence of several key factors.
First, while still challenging, it is easier and cheaper than ever to produce hardware – some components are open sourced (e.g. Arduino microcontrollers); 3D printing helps with rapid prototyping; specialized providers like Dragon Innovation and PCH can handle key parts of the production process, and emerging marketplaces such as Grand St. help with distribution. Crowdfunding sites like Kickstarter or Indiegogo considerably de-risk the early phase of creating hardware by establishing market demand and providing financing.
Second, the world of wireless connectivity has dramatically evolved over the last few years. The mobile phone (or tablet), now a supercomputer in everyone’s hand, is becoming the universal remote control of the Internet of Things. Ubiquitous connectivity is becoming a reality (Wi-Fi, Bluetooth, 4G) and standards are starting to emerge (MQTT). The slight irony of the “Internet of Things” moniker is that things are often connected via M2M (machine to machine) protocols rather than the Internet itself.
Third, the Internet of Things is able to leverage an entire infrastructure that has emerged in related areas. Cloud computing enables the creation of “dumb” (simpler, cheaper) devices, with all the intelligence processed in the cloud. Big data tools, often open sourced (Hadoop), enable the processing of massive amounts of data captured by the devices and will play a crucial role in the space.
Philips, Salesforce.com and Radboud university medical center (Radboudumc) are collaborating to develop cloud based technologies to deliver better patient-centered clinical applications. Earlier this year, Philips announced its alliancewith CRM company salesforce.com to develop an open, cloud-based health platform integrating the data of medical devices and data from personal devices and offering applications. Philips at the same time announced the first two clinical applications to run on this platform that allow doctors and other caregivers to monitor patients with chronic conditions in their homes. REshape will be using this new Philips HealthSuite cloud-platform and its applications to further develop and implement its innovative patient services, creating an environment in which patients are equal partners in care delivery.
Lucien Engelen, Director at REshape, says that in the past years, REshape has been actively experimenting with a number of innovative digital tools. The most ambitious of these is Hereismydata™, a combination of a personal health record, a community system for patients, caregivers and families and a connectivity tool for all kinds of medical devices and apps, fully embedded in the clinical process. “Our pilots and clinical trials made it clear that traditional hospital software does not offer all the required functionality to share device and treatment data in a secure way. Therefor the patients themselves should be able to own (at least a copy) of their own records. [...]
Radboudumc is the first European academic hospital to use the new Philips HealthSuite platform for actual clinical usage. One of the first pilots will be patients with the chronic condition COPD. They will be monitored with devices such as the Health Patch, a small sensor worn on the chest that enables clinical-grade remote monitoring. Pilots involving patients with heart disease, diabetes and pregnancy will follow in the next months.
“We are witnessing an explosion of personal medical data”, Engelen says, “but the real challenge is to integrate this data in the systems that doctors and other caregivers are actually using in their day-to-day processes and to make sure that doctors and patients can trust the data.” ...
rob halkes's insight:
Maybe we are witnessing a true partnership between health care professionals, a hospital, technology provider and patients here! I guess there are not too many examples of such alliances, whereas they from the basis and also conditional alliance to make it effective to better health outcomes! I for one do wish them the success they deserve!
New Evidence Points to Outcomes and Cost Benefits of Telemedicine in Managing Chronic Diseases
rob halkes's insight:
Great research and readings regarding the effects of ehealth!
Still free download till October 10th Here
Indeed, what we already guessed finds now its foundatoins in research. there's no way back. and the way forward is paved with lots of wuestions and issues how to do best. Luckily enough everyone, each institute of health care providers may find its own way. But remember cooperation is at the heart of it. You're not alone in providing care any more !
A group of researchers in Toronto have developed an app that aims to measure a patients alcohol withdrawal tremors and determine whether they are real or fake.
A statement from the University of Toronto explains that tremors, which are caused by alcohol withdrawal, are commonly treated with sedatives, but addicts sometimes fake tremors to get prescriptions for the medications.
In order to prevent doctors from prescribing drugs to patients who aren’t actually going through withdrawal, PhD candidate Narges Norouzi, Mount Sinai Hospital emergency physician Bjug Borgundvaag, and University of Toronto Associate Professor Parham Aarabi developed the app, which is still being studied — it’s not FDA-cleared or available commercially.
To use the app, patients hold a phone in their outstretched hand with the app opened on the screen. The app will then set a timer and measure the patient’s tremors for a period of time. The frequency with which the user’s hand shakes is measured, based on the iPhone’s accelerometer, to determine whether the patient is actually experiencing tremors.
“Our app may also be useful in assisting withdrawal management staff, who typically have no clinical training, and determining which patients should be transferred to the emergency department for medical treatment or assessment,” Borgundvaag said in a statement. “We think our app has great potential to improve treatment for these patients overall.”
While developing the app, the researchers conducted a preliminary study at three Toronto hospitals: Schwartz/Reisman Emergency Medicine Institute at Mount Sinai Hospital, St. Michael’s Hospital, and Women’s College Hospital. During the study, the app analyzed tremors from 49 patients and 12 nurses who attempted to replicate the symptom.
Read more at the blog here
rob halkes's insight:
It looks for instance by this example, that we are really in the stage of "Brainstorming mobile technology": exploring whatever we can create to be used mobile... And yes we can ;-)
But, imagine for a moment what a patient, and for that, also his care providers, need to coordinate, handle, organize data flows and review of them, to enable functional use of all those apps and applications.. Got it? - Indeed, let's begin integrating and organizing packaged applications! ;-)