E-HEALTH - E-SANTE - PHARMAGEEK
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Digitally Enabled Ecosystem to Address Underserved Chronic Disease - Digital Health Platform  #hcsmeufr #esante #digitalhealth

From catalyst.nejm.org

Disrupted by technologies, health care needs ecosystem-based solutions for integration and equitable access. This paper describes one solution that relies on a digital health platform to connect disparate participants and a convener to orchestrate technology-enabled customizable chronic disease management programs.
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Use of eHealth Technologies Common in MS Community  #hcsmeufr #esante #digitalhealth

From www.mdedge.com

Use of eHealth technologies is common in the multiple sclerosis (MS) population and facilitates the exchange of health care information with providers, according to a recent study.

 

However, use of eHealth and mHealth technologies varies substantially with sociodemographic factors, and health care providers need to be aware of these disparities as these technologies are increasingly leveraged in health care settings.

 

Researchers surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry in 2017 about their use of eHealth technologies using questions adapted from the Health Information National Trends (HINTS) 4 Cycle 4 survey. They found:

 

  • Of 6,423 participants included in the analysis, most participants were female, and white, with a mean (SD) age of 59.7 (10.1) years.
  • Overall, 5,408 (84.2%) had exchanged medical information with a health professional most often using a secure online portal (1,839, 28.6%), followed by email (1,327, 20.7%).
  • Of the 5,529 smartphone and tablet users, 2,556 (46.2%) used an mHealth app.

 

read original at https://www.mdedge.com/clinicalneurologynews/clinical-edge/summary/multiple-sclerosis/use-ehealth-technologies-common-ms

 

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Which eHealth interventions are most effective for smoking cessation?  #hcsmeufr #esante #digitalhealth

From www.dovepress.com

The Purpose of this study was to synthesize evidence of the effects and potential effect modifiers of different electronic health (eHealth) interventions to help people quit smoking.

 

Four databases (MEDLINE, PsycINFO, Embase, and The Cochrane Library) were searched in March 2017 using terms that included “smoking cessation”, “eHealth/mHealth” and “electronic technology” to find relevant studies. Meta-analysis and meta-regression analyses were performed.


Results: The review included 108 studies and 110,372 participants. Compared to nonactive control groups (eg, usual care), smoking cessation interventions using web-based and mobile health (mHealth) platform resulted in significantly greater smoking abstinence.

Similarly, smoking cessation trials using tailored text messages  and web-based information and conjunctive nicotine replacement therapy  may also increase cessation.

 

In contrast, little or no benefit for smoking abstinence was found for computer-assisted interventions. The magnitude of effect sizes from mHealth smoking cessation interventions was likely to be greater if the trial was conducted in the USA or Europe and when the intervention included individually tailored text messages. In contrast, high frequency of texts (daily) was less effective than weekly texts.

 

Conclusion

There was consistent evidence that web-based and mHealth smoking cessation interventions may increase abstinence moderately. Methodologic quality of trials and the intervention characteristics (tailored vs untailored) are critical effect modifiers among eHealth smoking cessation interventions, especially for web-based and text messaging trials. Future smoking cessation intervention should take advantages of web-based and mHealth engagement to improve prolonged abstinence. 

 

access the study report at https://www.dovepress.com/which-ehealth-interventions-are-most-effective-for-smoking-cessation-a-peer-reviewed-article-PPA

 

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Ces dix Français qui dominent la santé mondiale - #hcsmeufr #esante 

From weekend.lesechos.fr

On sait que la France a une solide tradition d'excellence en mathématiques. On sait aussi que Paris est devenu un hub technologique qui rivalise avec Londres et Berlin - le Salon VivaTech l'illustre chaque printemps. On le sait moins, mais dans le domaine de la recherche médicale aussi, des Français sont à la pointe. La preuve en dix portraits.
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Why Digital Health Is A Sector To Watch In Los Angeles  #hcsmeufr #esante #digitalhealth

From www.forbes.com

LA’s creative culture combined with its finance and broader technology expertise is leading to a rapidly growing community of local entrepreneurs focused on solving problems in one of the nation’s most challenging sectors: health care.
Art Jones's curator insight, October 19, 1:34 PM

The Rise of Silicone Beach 

 

Excerpt: The Los Angeles tech scene, sporting the moniker of Silicon Beach over the last few years, is becoming an innovation launchpad for health care delivery nationwide. LA’s creative culture combined with its finance and broader technology expertise is leading to a rapidly growing community of local entrepreneurs focused on solving problems in one of the nation’s most challenging sectors: health care. 

Major grant for development of ehealth program for cardiac rehabilitation  #hcsmeufr #esante #digitalhealth

From www.radboudumc.nl

Every year, more than 3 million people in Europe experience a heart attack. For half of them, this is not the first time. Most of these recurrent heart attacks can be prevented by improving the lifestyle after the first heart attack, for which patients are often offered cardiac rehabilitation. These programs consist of exercise and lifestyle recommendations. Cardiac rehabilitation is provided at specialized centers.
 
According to estimates, if all cardiac patients were to undergo cardiac rehabilitation, the mortality from myocardial infarctions could fall by 26 percent and hospital admissions by more than 30 percent. Despite these benefits, less than half of cardiac patients receive cardiac rehabilitation. This lack of participation is mainly due the distance to the cardiac rehabilitation centers, which patients experience as being too far. There are also many objections to the limited possibilities for taking an individualized program.
 
Research has shown that an internet-based rehabilitation program can achieve the same results as rehabilitation at a center. An e-health application for cardiac rehabilitation could therefore eliminate many obstacles for patients.

 

However, such an application is not yet available.

 

With Eurostar funding of € 1.9 million, a European consortium of researchers and companies will create CaRe, a mobile platform for cardiac rehabilitation.

 

Maria Hopman is creating this e-health program for cardiac rehabilitation together with a consortium of Danish and Swiss companies. Starting in 2021, the program will be available for physiotherapists and hospitals in Europe.

 

more at https://www.radboudumc.nl/en/news/2018/major-grant-for-development-of-e-health-program-for-cardiac-rehabilitation

 

 

 

 

nrip's curator insight, October 20, 1:37 AM

This week I am finding a lot of exciting pilots being funded well enough to take them to commercialization. Which is excellent. However, I find a number of such pilots seem to overlap in ideas and purpose. I wish there is collaboration of ideas between similar projects, especially, if not only to avoid another lack of interoperability scenario, arising 3-4 years from now, and causing pain for patients and care givers alike.

How Users Experience and Use an #eHealth Intervention Based on Self-Regulation. #study #hcsmeufr #esante #digitalhealth

From biblio.ugent.be

The objective of this study was to investigate how users experience the implementation of self-regulation techniques
in a Web-based intervention targeting physical activity and sedentary behavior in the general population.

 

Background: eHealth interventions show stronger effects when informed by solid behavioral change theories; for example,
self-regulation models supporting people in translating vague intentions to specific actions have shown to be effective in altering
health behaviors. Although these theories inform developers about which behavioral change techniques should be included, they
provide limited information about how these techniques can be engagingly implemented in Web-based interventions. Considering
the high levels of attrition in eHealth, investigating users’ experience about the implementation of behavior change techniques might be a fruitful avenue.


Results:

The techniques “providing feedback on performance,” “action planning,” and “prompting review of behavioral goals”
were appreciated by users.

However, the implementation of “barrier identification/problem solving” appeared to frustrate users; this was also reflected by the users’ website data—many coping plans were of poor quality.

Most users were well aware of the benefits of adopting a more active way of living and stated not to have learned novel information. However, they appreciated the provided information because it reminded them about the importance of having an active lifestyle. Furthermore, prompting users to self-monitor their behavioral change was not sufficiently stimulating to make users actually monitor their behavior.

 

Conclusions: Iteratively involving potential end users offers guidance to optimally adapt the implementation of various

manoj's curator insight, October 20, 4:38 AM
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Industriels de la e-santé : s’extraire de la concurrence en développant un “océan bleu”  #esante #hcsmeufr

From www.tmm-software.com

Des consultations à distance aux solutions de divertissement multimédia au chevet du patient, la e-santé offre de nombreuses applications, tant pour les établissements de soins que pour les patients. En France, le marché de la e-santé était évalué entre 2,2 et 3 milliards d'euros en 2016 et pourrait atteindre 4
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Un #guide pour prescrire le #sport sur #ordonnance #sante #hcsmeufr 

From www.medisite.fr

UN GUIDE POUR PRESCRIRE LE SPORT SUR ORDONNANCE
"On ne soigne pas seulement avec le médicament ou le bistouri": la Haute autorité de santé publie mercredi un guide pour faciliter la prescription de sport sur ordonnance pour des patients malades chroniques, y compris cardiaques ou diabétiques.
GIE_GERS's curator insight, October 17, 9:35 AM
UN GUIDE POUR PRESCRIRE LE SPORT SUR ORDONNANCE

"On ne soigne pas seulement avec le médicament ou le bistouri": la Haute autorité de santé publie mercredi un guide pour faciliter la prescription de sport sur ordonnance pour des patients malades chroniques, y compris cardiaques ou diabétiques.

Elizabeth Warren, colleagues pen critical letter on FDA Pre-Cert  #esante #hcsmeufr

From www.mobihealthnews.com

The FDA’s Pre-Cert program has fallen under new scrutiny as the agency received an open letter today from three senators: Elizabeth Warren (D-Mass.), Patty Murray (D-Wash.), and Tina Smith (D-Minn.).
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FDA roundup: The major device, app, and algorithm approvals of 2018 (so far)  #esante #hcsmeufr

From www.mobihealthnews.com

A collection of 31 approvals and clearances by the US Food and Drug Administration include several novel products.
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Digital Health Software Precertification (Pre-Cert) Program

From www.fda.gov

Digital Health Software Precertification (Pre-Cert) Program is a new voluntary program that will enable the FDA to develop a tailored approach toward regulating digital health and software technologies
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Matt Hancock launches tech vision to build the most advanced health and care system in the world  #esante #hcsmeufr

From www.gov.uk

The technology vision will be the foundation for a new generation of digital services that will meet the needs of clinicians, patients and managers.
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How to create healthcare models for underserved populations #esante #hcsmeufr #digitalhealth

From medcitynews.com

At the MedCity INVEST Twin Cities conference on October 11, keynote speaker Susan Jepson, who's the vice president of Upstream Health Innovations and interim CEO of Hitch Health, will discuss the significance of removing patient barriers to healthcare.
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How to build a lifetime of patient value #esante #hcsmeufr #digitalhealth

From medcitynews.com

[USA]

In an era of value-based care that places an increased emphasis on health outcomes, engaging with patients throughout their journey is critical and these are now possible using telehealth and mobile technologies.

 

Today, it’s all too common for healthcare providers to treat patients on a one-off, situational basis based on information provided at the moment. A patient’s healthcare journey doesn’t begin or end with a single appointment or medical procedure. On the contrary, it is a continuous cycle that requires consistent, personalized attention and communication throughout a patient’s lifetime to ensure optimal health outcomes.

 

Providers and health systems need to keep this at the forefront, and focus on delivering value and care throughout the patient’s healthcare journey. This is no small task, but a new breed of patient relationship management technologies are providing critical support for value-based clinics and physicians to maintain regular interaction with patients, support improved health outcomes and enhance the patient-provider relationship.

 

Value-Based Care and the Patient Journey

 

Under the new tenets of value-based medicine, providers are compensated based on patient outcomes and experiences, rather than on completed appointments and procedures. Consequently, healthcare providers are incentivized to deploy solutions that help them more quickly and effectively deliver care to their patients that drive maximal outcomes.

 

Rather than focusing on individual appointments or hospital visits, value-based care drives a more holistic approach to the patient journey. The patient journey starts before a patient’s first office visit and continues all the way through end-of-life care. It includes medical appointments and procedures, but also the care and wellness in between visits. Appointment reminders and confirmations, education about specific ailments or procedures and guidelines on how to prepare for a procedure are among the types of regular communication patients require throughout their journey to keep them informed and engaged.

 

To comply with the new goals under value-based care, providers are modernizing their infrastructure and processes to sustain the relationship management required to provide adequate patient guidance to maximize health outcomes.

 

Telehealth: Providing Patient Value Across Distances

 

The patient-to-primary care physician ratio in rural areas is 13.5 fewer physicians per 100,000 people than in urban locations. Similarly, there are only 30 specialists per 100,000 people in rural communities, versus 263 specialists per 100,000 patients in urban areas. In an effort to better reach and serve patients in rural areas, providers are increasingly adopting telehealth technologies.

 

The federal Health Resources and Services Administration (HRSA) defines telehealth as the “use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration.”

 

Earlier this year for example, the Centers for Medicare & Medicaid Services (CMS) unveiled its first Rural Health Strategy to improve patient access to high quality and affordable healthcare in rural areas of the U.S. Objectives within the strategy include the adoption of health IT to enhance patient access to health information and removing barriers to implement telemedicine. For example, Alabama, which ranks 46th for both overall health and diabetes, uses telehealth technology to educate diabetes patients and provide them with the tools they need for more effective self-care and self-management for optimal well-being.

 

Telehealth technologies support the

patient journey by removing barriers such as distance and access, making it easier for patients to not only get to care, but also to maintain control of their own health with the tools they need to sustain the level of self-care required in between doctor appointments and follow-ups. Though not yet widespread, a recent MGMA poll among practices found that 26 percent of organizations offer telehealth services, compared to 23 percent the previous year, and that another 15 percent plan to offer them in the future. Efforts such as that of CMS are likely to help telehealth continue to grow even further in the future.

 

The power of mobile

 

There is also an ongoing cultural shift within the industry that recognizes the role of the patient as a consumer. Consumers use mobile phones to manage almost all aspects of their lives, such as banking, making dinner reservations, shopping for groceries and scheduling babysitters. It is logical for the healthcare industry to follow this path to the mobile device to drive patient-provider communications and engagement.

 

Modern patient relationship technologies leverage the power of mobile to help patients manage their healthcare journey and to allow clinics to become more effective delivering care. Based on data from thousands of providers, results show that clinics that deploy mobile-first text messaging, for instance, (and automatically feed that data into the EHR system for smart waitlists etc.) communicate more effectively with patients. This includes:  

 

  • 45-50 percent patient response rates, compared to the current industry average of 10 percent

 

  • 15 percent increase in patient capacity utilization

 

  • 25 percent lower patient cancellation rates

 

  • Monthly referral schedule rate of 65 percent, compared to the 54 percent industry average

 

New advances in mobile technology also power clinical feedback and advice to ensure consistent guidance throughout the patient journey. Bot-powered text messaging can be customized based on medical specialty or the type of procedure in order to address the specific requirements of each patient. For example, if a patient has a scheduled colonoscopy, a few days before the procedure they will  receive customized text reminders from their physician to ensure they are following the correct procedures, such as avoiding high-fiber foods in the days before, or taking a certain medication. Communication can continue after the procedure as well, reminding patients to get plenty of rest and fluids and to make sure their recovery is on track.

 

In this age of advanced technology, provider-patient communication too often occurs in the form of pre-appointment emails or voicemail reminders. As providers continue to adjust and adapt to the ubiquitous use of mobile, so will the patient frustration decrease and clinic capacity increase. The metrics of success depend on delivering the right care to more patients effectively and at scale

 

What can we expect for the future?

 

In an era of value-based care that places an increased emphasis on health outcomes, engaging with patients throughout their journey is critical. Telehealth and mobile technologies enable providers to connect and engage with patients before and after appointments, as well as in-between to provide pre-emptive guidance and self-management instructions. These efforts and technologies provide patients with control of their patient journey and they will only become more important. We’re only now seeing the beginning of how modern technology can improve the healthcare system as a whole. Ongoing advancements to extend physicians’ ability to easily view and track patients’ medical history and treatments will further power the patient journey and build a lifetime of value for patients through constant education and improved access to care.

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Face à la digitalisation de la santé, les formations s'organisent #esante #hcsmeufr

From www.blogdumoderateur.com

La digitalisation des entreprises est au cœur du débat médiatique depuis de nombreuses années. Elles doivent évoluer et s'adapter aux nouveaux usages pour rester compétitives, pour continuer à satisfaire les exigences de leurs clients et pour accompagner leurs collaborateurs à acquérir les nouvelles compétences
Jean-Christophe Lévêque's curator insight, October 15, 9:28 AM

La montée en puissance des acteurs d cela santé autour du Digital devient indispensable et des formations spécifiques voient le jour pour accompagner ce besoin de transformation. #esanté #hcsmeufr #MBAMCI

Proposing a Transactional Model of eHealth Literacy: Concept Analysis | JMIR

From www.jmir.org

eHealth literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information.

 

Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth.

 

This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts.

 

The objective of this study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.

 

Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal.

 

Despite the transactional capabilities of eHealth, the role of “communication” in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.

 

read the full study at https://www.jmir.org/2018/10/e10175/

nrip's curator insight, October 8, 1:39 AM

eHealth literacy is the ability of internet users to locate, evaluate, and act upon web-based health information. The result of this study identifies that the role of “communication” in eHealth literacy remains underdeveloped.

 

Current frameworks and technologies do not account for physical and cognitive processing abilities necessary for multiway transactions.

 

A study of the Consumption(access by patients) patterns of a majority of patient education resources will be interesting. It may shed light on this underdevelopment being required or not.

 

The Single Market for Healthcare in Europe: Learnings for the U.S.

From www.healthpopuli.com

When I asked my longtime colleague and friend Robert Mittman, with whom I collaborated at Institute for the Future for a decade, how he managed international travel and jet lag, he said simply, “The time zone you’re in is the time zone you’re in.” This lesson has stayed with me since I received Robert’s advice over twenty years ago. Over the next two weeks, as I work alongside colleagues and clients in the EU and soon-to-Brexit UK, I am in time zones five and six hours later than my home-base of US Eastern Time. But the time zones I’m working and living in are the time zones I’m in. Here, healthcare is evolving toward a Single Market in the EU. [When I’m in the UK later this week, I’ll address the challenge for the UK, Brexit and the National Health Service. This post focuses on the larger EU of which, for the moment, the UK is a member]. While national health services funding and delivery modes will still have local models of organization and control, some over-arching concepts and cooperation are being forged. Two key issues are in my work-radar this trip: digital health cross-border, and health innovation funding. First, some context: in 1957, six European nation-states came together to create the European Economic Community (France, West Germany, Italy, and the Benelux countries). Today, the European Union has grown to 28 countries, and priorities have evolved to bring these nations closer together as a health community. Last month, a document synthesized a vision for transforming health and care in a digital single market, adopted by the European Economic and Social Committee (EESC). In summary, three over-arching issues come out of the paper: ensuring health citizens’ secure access to their health data within nations and across EU borders; enabling personalized medicine through the shared European data infrastructure; and, assuring citizen empowerment with digital tools for feedback and person-centered care. This report included survey data conducted among 1,400+ EU citizens to gauge their interests and concerns about digital health, finding that: 83% believe that sharing health data could be benefit to improve treatment, diagnosis and prevention of diseases across the EU 73% see improved possibilities for medical research as a reason to support cross-border transfer of their personal health data — greater than for the purpose of their own treatment (68%) Over one-half of EU health citizens are concerned about the risks of health data privacy breaches and cybersecurity. Nine in ten Europeans say that citizens should be able to manage their own health data, the pie chart illustrates with data from the survey, with two-thirds “strongly” agreeing with the idea. Note that 90% of health organizations agree (NET strongly agree + agree) that citizens should also manage their own health data. The rationale beneath self-control of health data are the potential for better patient self-care/management, value for the healthcare system with improved outcomes and efficient care pathways, and economic and societal value translated into people being able to more fully participate in social and economic systems, continuing to earn incomes and bearing lower healthcare costs. On the downside, major barriers to peoples’ willingness to share their health data center on risks of privacy breaches and cybersecurity risks. For organizations, the biggest concern is the “heterogeneity of electronic health records” and data quality and reliability. The former is a pain point especially shared by U.S. providers — the lack of interoperability. There remains a gap in European health citizens’ access to digital health and care. That is, peoples’ demands and interests in accessing digital health tools and access channels isn’t met by the supply side of providers in the EU. The report concludes with the need for more and sustained EU investment in research and innovation, sharing best practices across EU nation border, and harmonizing approaches for feedback on quality. Health Populi’s Hot Points:  The EU Digital Single Market report on healthcare transformation gives us a snapshot of the consumer (EU health citizen) demand side for digital health access. What of the supply side and innovation to meet those needs? A new analysis from McKinsey identifies opportunities for investing in European healthcare. These hot areas range from infrastructure investments to niched patient-facing self-management tools. Being successful in this market requires deep knowledge of European healthcare systems — regulations, reimbursement schemes, the private healthcare providers, among cultural and clinician workflows region-by-region. If you’re intuiting a fragmented landscape, you’re reading me right. The McKinsey team characterizes this landscape in the graph here, doing a fine job at arraying the fragmentation continuum with market potential by healthcare segment. For example, Oncology clinics are extremely fragmented but have tremendous untapped market opportunity. At the opposite extreme, dialysis clinics are highly consolidated with low opportunity for investors, McKinsey gauges. Among McKinsey’s recommendations is one I’m especially focusing on: forging “unofficial networks,” coupling with vertical integration. What I know-I know from my time in healthcare working both in the U.S. and Europe is that it takes a village to re-imagine and re-make healthcare with the Quadruple Aim in mind. That village crosses siloes and market segments, and will design, build and leverage digital platforms that take advantage of data — created both in healthcare settings and via person-generated wearable tech and home/person-based remote health monitoring tools. While our national health systems differ in terms of payor regimes and workflows, there’s one universality we find through comparing the EU report with the many health consumer surveys I cover here on Health Populi: patients around the world want access to their health data, and see the benefits of health data altruism: sharing with other patients and health citizens. One of many questions for U.S. healthcare that emerges from my look into remote health monitoring across Europe is how the 50 U.S. States can forge a national telehealth approach, given professional state licensure regulations. There are virtual health programs operating across Europe — countries — whereas, in the U.S., it can be difficult to get a second opinion organized between a doctor in, say, Pennsylvania and a colleague-specialist in New York state. With the understanding that patients want access to healthcare data, and to those expert consults between doctors working across U.S. state borders, I leave you with a link to an investigative article on NBC News last week about U.S. patients’ continued difficult access to “their” own data. This story features the profoundly personal experiences of close friends in my own healthcare community, Regina Holliday and Dave DeBronkart.  
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Digital diabetes: Perspectives for diabetes prevention, management and research #hcsmeufr #esante #digitalhealth

From www.sciencedirect.com

Digital medicine, digital research and artificial intelligence (AI) have the power to transform the field of diabetes with continuous and no-burden re…
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When Digital Devices Distract Doctors, Mistakes Can Happen #hcsmeufr #esante #digitalhealth

From thedoctorweighsin.com

Digital distraction in healthcare is emerging as a great threat to patient safety and physician well-being.[1] This phenomenon involves the habitual use of personal electronic devices by healthcare providers for nonclinical purposes during appointments and procedures.[2] Some call it “distracted doctoring.” Matt Richtel, a journalist for the New York Times who won a Pulitzer Prize for his work on distracted driving, coined the term “distracted doctoring” in 2011. [3] Like driving, attending to a patient’s complex care needs is a high-risk activity that requires undivided attention and presence in the moment to ensure the safety and protection of others.

But the threat might more aptly be called “distracted practice,” as it impacts all healthcare workers and staff. While distraction is particularly concerning in the operating room, emergency room, and critical care areas, it can impact all healthcare settings—including the office practice. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients. And the consequences can be devastating.

Our Devices Are Addictive

In today’s electronic culture, it has become unthinkable to be without personal electronic devices. Growing evidence shows that our personal electronic devices and social media are addictive.[4] The reason is dopamine. Our dopamine systems are stimulated by the unpredictable, small, incomplete bursts of information with visual or auditory cues. For example, we are never quite sure when we will receive a text message and from whom. We may keep checking to see who liked our recent Facebook post. And when our devices ding or vibrate, we know our reward is coming. Yet as when gambling or playing the lottery, the anticipation of the reward is (usually) better than the reward itself. This results in more and more of what some call “seeking” and “wanting” behaviors. Then instant gratification encourages dopamine looping, and it becomes harder and harder to stop the cycle.

Distraction can also be both a symptom of and a contributor to healthcare provider stress and burnout. As a symptom of burnout, digital distraction is a way to escape a stressful environment. As a contributor to burnout, digital distraction impedes human interaction because of the sheer volume of data-demanding our attention.

Medical Malpractice Implications

For most healthcare providers, distractions and interruptions are considered part of the job; it is the nature of their work. If we consider healthcare distraction on a continuum, on one end are distractions related to clinical care (e.g., answering team member questions or responding to surgical equipment alarms). On the other end of the continuum are distractions unrelated to clinical care (e.g., making personal phone calls, sending personal text messages, checking social media sites, playing games, or searching airline flights).

From a litigation perspective, the distinction between distractions related to clinical care and those unrelated to clinical care is important. In a medical malpractice claim where there is an allegation that an adverse event was caused by distracted practice, a distraction caused by a clinical-care-related activity may be found to be within the standard of care and is, therefore, often defensible. But where it can be shown that the distraction was caused by non-patient matters, the plaintiff’s attorney will certainly use that against the defendant. In these situations, the defendant’s medical care may not even enter the equation, because during eDiscovery the metadata (i.e., cell phone records, scouring findings from hard drives) serves as the “expert witness.” Even if the defendant’s clinical care was within the standard, the fact that there are cell phone records indicating that the healthcare provider was surfing the Internet or checking personal e-mail may imply distraction and could potentially supersede all other evidence.

Preventing Distractions

Complex problems require a multifaceted approach. Organizations, teams, and individuals all should take responsibility and ownership for reducing the risks associated with digital distraction. The following are risk management strategies to prevent distractions and enhance patient safety.

Organizations

  • Create awareness

    • Recognize the extent of the problem and risks.
    • Model appropriate personal electronic device use behaviors.
    • Tier communication to batch non-emergent messages.
    • Refrain from sending texts on non-urgent matters.
    • Do not expect immediate responses for non-urgent matters.
  • Educate system-wide

    • Train all healthcare providers and staff at orientation and conduct annual refreshers on safety concerns, legal risks of using personal electronic devices when providing care, device-user etiquette, and the addictive potential of technology.
    • Use simulation-based learning where distractions and interruptions are introduced during high-risk procedures.
    • Use case studies of real-life examples where distraction was alleged to play a role in an adverse event.
  • Deploy technology solutions

    • Manage facility-issued devices.
    • Create technology-free zones.
    • Limit Internet access to work-related sites only—EMR, labs, images, pharmacy formulary, state Rx databases, and decision support/cognitive aids.
  • Enforce

    • Monitor compliance with system-wide protocols and guidelines.
    • Clearly define how personal electronic devices are used in patient care areas.

Teams

  • Reinforce situational awareness and mindful practices with your team or department through:
    • Unit-specific protocols: “Sterile Cockpit” and “Below 10,000 Feet” protocols limiting or eliminating non-essential activities during critical phases of procedures and high-risk activities.
    • Empowering every team member to speak up when they have a safety concern. For example, encourage team members to speak up when they notice another member is so focused on a personal electronic device that he or she has lost situational awareness about the patient’s clinical condition.
    • Applying TeamSTEPPS® principles: leadership, situational awareness, mutual support, and communication.
  • Create a process where employees can be reached via a call to a central location, with messages relayed to the employee by a staff member. This alleviates employees’ desire to have their personal electronic devices nearby in case of a family emergency.
  • Monitor compliance as part of the team’s quality measures.

Individuals

  • Take personal responsibility—ignore distractions, especially during high-risk procedures, and make sure to speak up, set an example, and remain vigilant.
  • Practice situational awareness:
    • Pay attention to what is happening in the present moment.
    • Increase attention, focus, and concentration.
    • Leave your device behind.

New CME Courses Address Distracted Practice Concerns

Two new CME courses from The Doctors Company, How Healthcare Leaders Can Reduce Risks of Distracted Practice in Their Organization and The Risks of Distracted Practice in the Perioperative Area, address addiction to personal electronic devices and provide strategies that individuals and organizations can use to minimize the patient safety risks associated with distractions from these devices.

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#PLFSS 2019: un nouveau cadre pour l'utilisation des #logiciels d'aide à la #prescription #esante #hcsmeufr 

From www.ticsante.com

L'article 32 du projet de loi de financement de la sécurité sociale (PLFSS) pour 2019 prévoit un nouvel encadrement des logiciels d'aide à la prescription et à la dispensation, ainsi que des incitations pour améliorer le recours à ces outils par les professionnels de santé.
GIE_GERS's curator insight, October 9, 3:14 AM

L'article 32 du projet de loi de financement de la sécurité sociale (PLFSS) pour 2019 prévoit un nouvel encadrement des logiciels d'aide à la prescription et à la dispensation, ainsi que des incitations pour améliorer le recours à ces outils par les professionnels de santé.

Beyond Limits - How the internet is becoming a part of us #esante #hcsmeufr #digitalhealth

From www.bbc.com

For Professor Yuval Noah Harari from the Hebrew University of Jerusalem, the merging of man and machine will be the “greatest evolution in biology.”

 

“I think it is likely in the next 200 years or so Homo sapiens will upgrade themselves into some idea of a divine being, either through biological manipulation or genetic engineering of by the creation of cyborgs, part organic part non-organic. It will be the greatest evolution in biology since the appearance of life. Nothing really has changed in four billion years biologically speaking. But we will be as different from today’s humans as chimps are now from us.”

 

But what role will the internet and all its devices – ever smaller and ever closer to us – play in this great evolution? Meet E-man…

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Estonia and Finland will start exchanging digital prescriptions at the end of 2018  #hcsmeufr #esante

From www.euractiv.com

Estonia and Finland will start exchanging digital prescriptions at the end of the year, in a groundbreaking move that Estonian Health Minister Riina Sikkut said she hoped other EU countries will follow.

 

Speaking to EURACTIV.com on the sidelines of the European Health Forum in Gastein, Austria, Sikkut said that in Estonia, it is common practice for healthcare professionals to use the e-health system to exchange patient medical records.

 

“But it is also important for people who have a need for healthcare services abroad to have his or her health data available to a doctor, nurse or a pharmacist so that they could also provide quality healthcare services and continuity of care,” she said.

 

The cross-border flow of data has taken centre stage in the discussion in Brussels. Right now, when citizens move to another EU member state, their healthcare data is in fact simply “lost”.

 

Advocates of the digitisation of healthcare say data mobility, or the “5th freedom”, in the EU could unlock the potential of innovation in the sector and make EU patients’ lives easier.

 

Estonia is known for its digitisation push in all sectors, and during its EU Presidency (July-December 2017), it took significant steps to create a “coalition of the willing” of EU member states to speed up healthcare data mobility in Europe.

 
 
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