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Dubai to optimise stroke management | GulfNews.com

Dubai to optimise stroke management | GulfNews.com | Digital Medicine | Scoop.it
First telestroke facility in collaboration with Rashid Hospital will link at least 14 hospitals next year
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UPMC's big data approach slashes readmissions | Healthcare IT News

UPMC's big data approach slashes readmissions | Healthcare IT News | Digital Medicine | Scoop.it
Looking to slash your readmission rates using big data but not sure where to start? It's best to hear the stories from the folks who have done it successfully. UPMC's analytics team is one of groups ahead of the curve.
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A second opinion could save your life

A second opinion could save your life | Digital Medicine | Scoop.it
At age 29, Los Angeles resident Liza Bernstein was diagnosed with early-stage breast cancer .
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Mayo makes case for Medicare reimbursement for telemedicine

Mayo makes case for Medicare reimbursement for telemedicine | Digital Medicine | Scoop.it
Mayo Clinic says electronic intensive care unit services could pack a bigger punch if lawmakers would bolster Medicare reimbursement.
Ver2DigiMed's insight:

The barriers to telemedicine are slow to change in the US. We can leapfrog healthcare here in MENA. We have to resources and a government with the right vision!

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New Screening Tests for Hard-to-Spot Breast Cancers

New Screening Tests for Hard-to-Spot Breast Cancers | Digital Medicine | Scoop.it
For women with dense tissue, mammograms can be less accurate. New tests offer better detection but often more false alarms.
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Why Telemedicine's Time Has Finally Come

Telemedicine may just be the biggest trend in digital health in 2015. As a partner focused on digital health investments at venture capital firm AMV, I spend a lot of time crisscrossing the country chatting with leading healthcare providers and insurers about their technology needs. By far the area they [...]
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What is person-centred eHealth?

What is person-centred eHealth? | Digital Medicine | Scoop.it

What is person-centred eHealth?

 

Does the wording imply that ehealth in general is not person-centred. Well. To elaborate these questions further, I need to make some assumption and define what I mean by person-centred care and eHealth. 

 

Ehealth is according to  Eysenbach et al (2001) ” an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology”.

 

EHealth is not a technical solutions per se, it is also a state of mind and attitude about how we want to communicate and in that sense it could be a good tool in providing support for PCC. 

 

The core in my exposition is grounded on the definition of PCC found within GPCC. I have already discussed this in my previous blogs, and will for the matter of simplicity call it gPCC (Gothenburg person-centred care approach). The most central aspect in gPCC is the mutual acceptance that a person always is intradependent of the other person. At the core of the definition is the concept of partnership.

 

The juridical meaning of the word is that two persons reach an written or verbal agreement (contract) to perform certain commitments. Within the gPCC approach, this agreement would be manifested by a health and care plan that is agreed upon by all involved stakeholders.  So partnership needs at least two people that agree upon a certain approach in order to reach a certain outcomes.

 


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Why and how we can set up a clinic on every mobile phone - Technology Zimbabwe

Why and how we can set up a clinic on every mobile phone - Technology Zimbabwe | Digital Medicine | Scoop.it
Telemedicine is now being trialed in Zimbabwe. What are its benefits and what approach would work in making it mainstream?

Via Lionel Reichardt / le Pharmageek
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How one health system is using telemedicine in ICUs to combat staff ...

How one health system is using telemedicine in ICUs to combat staff ... | Digital Medicine | Scoop.it
Geisinger Health System's move to integrate telemedicine with intensive care units through an eICU system is helping it resolve growing problem of staffing shortages.

Via Paul Epping
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Mobile Telestroke Set to Have Major Impact on Patient Care in 2015

Mobile Telestroke Set to Have Major Impact on Patient Care in 2015 | Digital Medicine | Scoop.it

“Today, this vision of integrating mobility with telestroke is a reality. Learn how mobile telehealth can help you deliver better care and lower costs.”


Via Philippe Marchal, Lionel Reichardt / le Pharmageek
Ver2DigiMed's insight:

Time is Brain. Getting patients the treatment they need in the minimal time allotted during a stroke is pertinent to recovery. Gaining access to the right knowledge in that window of time can mean the difference of life or death. If it is as simple as video conmmunications and store and forward technology we have the means to make this happen. 

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Healthcare in the Cloud | Rickscloud

Healthcare in the Cloud | Rickscloud | Digital Medicine | Scoop.it
Cloud-based services are becoming more widely adopted by healthcare organizations. The past year has seen a surge of interest regarding the potential of cloud

Via Giuseppe Fattori
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Bridging the Gap in Precision Medicine @UCSF

Bridging the Gap in Precision Medicine @UCSF | Digital Medicine | Scoop.it
Bridging the Gap in Precision Medicine @UCSF Reporter: Aviva Lev-Ari, PhD, RN Bridging the Gap in Precision Medicine @UCSF By Pete Farley on November 07, 2014 SOURCE   For entertainment giants such...
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Connected Care: 3 Surprising Patient Safety Pluses

Connected care isn’t just about connecting stakeholders to each other. It’s about delivering better – and safer – care by making those connections work.
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Digitalization and Connectivity lead to improved patient safety

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The Internet of Things Is Far Bigger Than Anyone Realizes | WIRED

The Internet of Things Is Far Bigger Than Anyone Realizes | WIRED | Digital Medicine | Scoop.it
When people talk about “the next big thing,” they’re never thinking big enough. It’s not a lack of imagination; it’s a lack of observation. I’ve maintained that the future is always within sight, and you don’t need to imagine what’s already there. Case in point: The buzz surrounding the Internet of Things. What’s the buzz?…
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Telemedicine in the Middle East, the time is now

Telemedicine in the Middle East, the time is now | Digital Medicine | Scoop.it
The time is now. (Image via CommsMEA) In 2001, a team of French and American physicians in New York made history by remotely conducting surgery on a patient…
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Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis

Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis | Digital Medicine | Scoop.it
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.
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A New Strategy to Narrow Health Disparities: Humanizing eHealth

A New Strategy to Narrow Health Disparities: Humanizing eHealth | Digital Medicine | Scoop.it
Evidence suggests that when some or all of these considerations are taken into account, health disparities can be effectively reduced -- even in populations that traditionally might not prefer new technologies, such as older adults....
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Remote Patient Monitoring Lets Doctors Spot Trouble Early

Remote Patient Monitoring Lets Doctors Spot Trouble Early | Digital Medicine | Scoop.it
Health-care providers use wireless devices to track vital signs of people with chronic conditions, allowing them to detect problems early and make adjustments in care without office visits.
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4 Reasons Telemedicine Will Trend Upward in 2015

4 Reasons Telemedicine Will Trend Upward in 2015 | Digital Medicine | Scoop.it

Telemedicine may be one of the biggest digital health trends we will see in 2015.

Why? Well for a number of reasons. But here are the four most prominent.

1. Faster internet connections and better software will provide a better video chat experience than before.


2. With mobile devices, patients can consult a doctor from anywhere.


3. The adoption of electronic health records makes it easier for doctors to access patient records.


4. Patients are comfortable with asynchronous messaging, which can be more time-efficient for doctors.


From the provider’s perspective, telemedicine has the potential to save money and make better use of time. And from a patient’s perspective, telemedicine means shorter wait times and ease of access.  

While the youth would seem most likely to use technology for health care, telemedicine could also have a major impact on the older generation as they are more likely to have difficulty traveling to see a doctor in person.

In the last few years, more and more patients have increasingly looked to retail pharmacies in their neighborhoods for routine health care services because it’s more convenient than visiting their doctor. The logical next step is that they won’t have to leave their homes at all. This is where telemedicine comes in.

Thanks to startups like Doctors on Demand, Medicast and Twine Health, consumers are already being allowed direct access to doctors through their smartphones. In the future, providers may partner with platforms such as these to connect their doctors with patients.

Additionally, these apps could be offered through employers or insurance companies to help reduce costs or improve the quality of care.

Telemedicine has the capability to not only become an investment opportunity, but a trend that can improve the doctor-patient relationship as well.

 


Via Technical Dr. Inc.
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The Future of Wearables Isn't a Connected Watch | WIRED

The Future of Wearables Isn't a Connected Watch | WIRED | Digital Medicine | Scoop.it
Tech that attaches to our bodies doesn’t have to do it all. It just has to do one thing well.
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Computers Replacing Doctors, Innovation and the Quantified Self: An Interview with Atul Gawande | The Health Care Blog

Computers Replacing Doctors, Innovation and the Quantified Self: An Interview with Atul Gawande | The Health Care Blog | Digital Medicine | Scoop.it

Atul Gawande is the preeminent physician-writer of this generation. His new book, Being Mortal, is a runaway bestseller, as have been his three prior books, Complications, Better, and The Checklist Manifesto.

One of the joys of my recent sabbatical in Boston was the opportunity to spend some time with Atul, getting to see what an inspirational leader and superb mentor he is, along with being a warm and menschy human being. In my continued series of interviews I conducted for The Digital Doctor, my forthcoming book on health IT, here are excerpts from my conversation with Atul Gawande on July 28, 2014 in Boston.

I began by asking him about his innovation incubator, Ariadne Labs, and how he decides which issues to focus on.

Gawande: Yeah, I’m in the innovation space, but in a funny way. Our goal is to create the most basic systems required for people to get marked improvements in the results of care. We’re working in surgery, childbirth, and end-of-life care.

The very first place we’ve gone is to non-technology innovations. Such as, what are the 19 critical things that have to happen when the patient comes in an operating room and goes under anesthesia? When the incision is made? Before the incision is made? Before the patient leaves the room? It’s like that early phase of the aviation world, when it was just a basic set of checklists.

In all of the cases, the most fundamental, most valuable, most critical innovations have nothing to do with technology. They have to do with asking some very simple, very basic questions that we never ask. Asking people who are near the end of life what their goals are. Or making sure that clinicians wash their hands.

Once we’ve recognized the recipe for really great performance, the second thing we’ve discovered is that our most important resource for improving the ability of teams to follow through on those really critical things is data. Information is our most valuable resource, yet we treat it like a byproduct. The systems we have – Epic and our other systems – are not particularly useful right now in helping us execute on these objectives. We’re having to build systems around those systems.

The third insight is that, for the most part, the issues have less to do with systems than with governance. The people who are buying these systems, installing these systems, and determining how they’re to be used… What are they responsible for? What are their objectives? We’re having to figure out how to get quality and outcomes higher on the list of priorities of everybody running health systems.

Our dumb checklist, or our incredibly sophisticated predictive analytics algorithm, or that incredibly expensive EHR system… none of those change that fundamental failure – the failure of governance. And none of them can, no matter how you design them.

Gawande raised the example of hospitalists. He asked me about my group at UCSF, which has – by focusing on performance improvement as our core mission – become a key innovation engine at our institution.

AG: I think your hospitalist example is really important. Over and over again, it’s the pattern I see: a powerful idea creates a momentum of its own. When you’ve shown that there’s an obvious better way to take care of people. It’s controversial, and hospitalists can be used in ways that destroy the original intent. I’m sure you think about this all the time.

But when it works, it forces the leadership change. Leadership didn’t create hospitalists. Hospitalists created leadership. I think that’s the way it happens.

The same kind of thing happened with anesthesia. People didn’t say, “Oh, we have to find a better way to manage the pain of patients, because surgery is causing horrible suffering.” Somebody came up with an idea, and demonstrated that you could relieve this problem. But it required incredible system change. You had to double the number of people working in operating rooms at a time when the United States had a lower GDP than China does today. “We’ve got a better way of doing surgery. Oh, and it will involve doubling the number of physicians you have providing the care?” Is that a great model? It was dismissed as totally non-viable, can’t work. But it didn’t matter. It was too important, and it became the driver of leadership change, rather than the other way around.

A similar thing happened with Paul Farmer. There were debates for a decade about whether you could treat HIV in poor patients. Oh they don’t have watches, they can’t take the drugs, they can’t do this, they can’t do that. Farmer is like, “Fuck it!” I am going to Haiti, and I’m going to do it in a little old clinic in the middle of nowhere. And no, they didn’t change a whole country … but they changed a paradigm.

I think that’s the cool thing, that it’s not the technology. It was the values and the core idea that demonstrated you could accomplish this, that got you there.

I asked Gawande a question I asked most of my interviewees: Will computers replace physicians?

AG: The variousness of the healthcare world is pretty extreme. When we look at the way that disease presents itself, we’re moving increasingly away from science. When it turned out that lung cancer is not one disease, but rather that it’s four or five different histologic subtypes, that made it more complicated. Now we know there are 47 – and the number is growing – genes that, in different combinations, govern the behavior of those cancers. Forty-seven genes, and then you look at the multiples of different ways that people have these genes. Now we learn that the epigenetics and the expression of those genes are incredibly dependent on the environment. Did they smoke, how did that affect the genes? Did they have any kind of industrial exposure? How old are they at the time that the cancer appears?

Our cells on our little Excel spreadsheets are getting smaller and smaller and smaller. We’re getting back to the world of the 18th century “art of medicine,” where everything is becoming an “eyeball test.” The danger is that it becomes actually increasingly data-free – that every single person becomes a case of one. That becomes impossible to learn from. Period.

Where we’re moving, I think, is towards saying, “I have a class of people. I’m going to try Process A on this class of people who have some combination of these different genes,” and stuff like that. And then, does that process lead to better outcomes? The processes will be things like, “I’m going to watch them for three months. Then if X happens, I’m going to do an operation. If Y happens, I’m going to give them chemotherapy.” That increasingly becomes the way we learn.

RW: In your work as a physician, do you think care is getting better or getting worse?

AG: I think it’s massively better.

RW: Why?

AG: It’s fundamentally because of values, more than technology. I think we’ve changed our values over time. That patient suffering matters. I remember as a surgical trainee, I was expected to inflict levels of pain that today are just not acceptable. In my first month as a resident, I went into an operation to do a rib removal on a young girl. I’d never done one before; I had a month of operating experience. A fellow was standing at the door in his scrubs, saying, “Yeah, yeah, yeah, cut there.” The attending is in another room. I didn’t know what the hell I was doing.

The culture was, even to suggest that was a problem, meant you were weak.

Gawande asked me how I perceived the training environment today – particularly the tension between the patient and the technology.

RW: The residents’ instinct about teamwork is much better than mine was. I mean, the idea of my caring about what the nurses thought just wasn’t on my radar screen. And the residents’ instinct to get back to the bedside – when they’re spending all their time on the computers, they feel this loss and I think they’re trying to reconnect with their patients. We’re trying to create structures to allow that to happen.

But it’s hard – the residents feel they’re caught up in this world where everything they need to know is on the computer screen. That’s creating angst in their day-to-day life. You go up to the floor of the medical service in my hospital, and there are no doctors there. They come, they see the patients, and then they escape to this tribal room where all 15 residents hang out together, each doing his or her computer work. That means that many of the informal interactions that used to occur between the docs and the nurses, or the docs and the patients and their families, have withered away.

AG: Everything that they’re measured on and that defines their success happens outside the patient’s room.

RW: Correct.

AG: There’s a difference in surgery training. Everything that you’re measured on and that matters happens in the operating room. Although the patient’s asleep, the residents are having to work on their people-to-people interactions. How do you handle yourself with the nurses? How do you handle yourself with the doctors? What are your skills? They’re trying to figure it out and navigate it. It’s often a complete mystery to the students, and for a long time to the residents, too.

But except in the most egregious cases where you really piss off a patient, their success – being labeled an A versus a B – relates to “how much do I really know this patient?” It’s not getting my to-do list done for the day. Yet getting through the to-do list is the dominant task.

And we’ve both contributed to discoveries that indicate that all these little steps on the to-do list matter. It’s become an endless list of details that really, really, really matter. Do you have the right combination of antibiotics? Is the head of the bed at 30 degrees? When I think about the to-do list that I had when I was an intern, and the to-do list that the residents have today – today’s is just massively longer.

I closed by asking Gawande about the concept of the Quantified Self – patients wearing sensors and accumulating all kinds of personal data. While he is generally supportive of the concept, he has a concern, one that echoes the central theme of Being Mortal.

AG: I worry that we could become tyrannized by a combination of experts and sensors that have no close relationship to our priorities. That’s why I just keep coming back to the values. We’re here to alleviating suffering. I think it’s about this deeper connection we all have to something important.

 


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After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare

After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare | Digital Medicine | Scoop.it

In the news this week is the national effort to cut hospital readmissions by penalizing hospitals with high rates.  Dartmouth atlas has published this map of 2009 data showing regional variation in 30-day readmission rates. Hospital readmissions are sentinel events that often signal gaps in the quality of care provided to Medicare patients. There are many different reasons for higher readmission rates across certain regions and hospitals, including differences in patient health status, the quality of inpatient care, discharge planning and care coordination prior to discharge, and the availability and effectiveness of ambulatory services in the community. This report also demonstrates the importance of the general tendency of health care systems to use the hospital as a site of care. The combination of these factors will differ across communities and systems as each faces its own challenges in keeping patients well and out of the hospital.


Via Seth Bilazarian, MD
Ver2DigiMed's insight:

Discharge Planning is proving to be a larger and larger financial burden of hospitals. A comprehensive discharge management program including remote patient monitoring and secure video conferencing between patient and care provider has proven to reduce hospital readmissions and allow patients to be discharged earlier freeing up hospital beds. 

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Chronic Diseases Are Killing More in Poorer Countries

Chronic Diseases Are Killing More in Poorer Countries | Digital Medicine | Scoop.it

With the shift in Deaths from chronic diseases such as cancer and heart disease have risen by more than 50 percent in low- and middle-income countries over the past two decades, according to a report.

Ver2DigiMed's insight:

With a global shift in disease to non-communicable diseases, now even affecting low income countries, demand for a better approach to treatment is heightened. Chronic disease management needs to be holistic, accessible, consistent, constant, and collaborative.  Digital Medicine can provide such an approach. 

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IBM's Watson is better at diagnosing cancer than human doctors (Wired UK)

IBM's Watson is better at diagnosing cancer than human doctors (Wired UK) | Digital Medicine | Scoop.it
Watson, IBM claims, is better at cancer diagnosis than human doctors, and its deployment could also reduce healthcare costs

Via Giuseppe Fattori
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Digital Transformation is About Empathy First and Technology Second - Brian Solis

Digital Transformation is About Empathy First and Technology Second - Brian Solis | Digital Medicine | Scoop.it

Every day, there’s seemingly yet another disruptive trend that emerges out of nowhere which affects consumer behavior and the future of everything along with it. Many of you already follow some of the most notable trends disrupting markets today and I know you’re devising new strategies as a result in order to compete in these ever shifting markets.


Via Giuseppe Fattori
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