eHealth - Social Business in Health
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eHealth - Social Business in Health
ehealth, integrating care, health monitoring, on line communication, interaction and (mobile) technology to care for health better
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How does Precision Medicine look at the end of 2016? - The Journal of Precision Medicine

How does Precision Medicine look at the end of 2016? - The Journal of Precision Medicine | eHealth - Social Business in Health |

In an opinion piece published online in Medical Economics, part of the Modern Medicine Network, Henry Anhalt, DO discusses the current status of Precision Medicine as 2016 draws to a close. Reflecting on President Obama’s 2015 State of the Union address, in which he launched the Precision Medicine initiative – a program that aims to revolutionize health outcomes by taking a personalized approach to medicine and research – he acknowledges the ongoing debate as to whether this approach to treating disease can truly deliver on its promises. He also recognizes the uncertainty for precision medicine that lies ahead as the US enters a new presidential term.
One of the solutions Anhalt proposes is for clinicians to ask themselves how they can implement the tenets of precision medicine when treating patients in the immediate present. His suggested answers to this question included enabling patients to access their own health record data: “So they can review it when they need to and share it with others when they want”. He then discussed The U.S. Department of Veterans Affairs’ push for patient access to health records through its pioneering “Blue Button” initiative and how it is a step in the right direction towards this goal.
Another suggestion involves how the community engages study participants in research, as: “There are many ways patients today can participate in research without requiring a visit to a large research hospital.” Anhalt continues, “For example, if patients can download their health records, one easy opportunity they may have is to donate them to research. For people with Type 1 diabetes, we offer a patient platform that allows that patient to connect with others who have Type 1 diabetes and participate in online research. To truly achieve the promise of precision medicine, it’s going to require that our patients have the understanding and motivation to become citizen scientists.”
He concluded with advice for clinicians that even if today they cannot practice precision medicine in full, they should at least strive for individualized care. “As physicians, we are trained to ask questions such as, ‘What are your symptoms; how long have you had these symptoms?’ and so forth. But what are the questions we’re not asking that help us get a more holistic view of a patient’s health?” He argues that greater empathy in clinical interactions could help achieved more personalized care in the present.
Finally, Anhalt points out that, despite the wealth of precision medicine research is being done, there is a long way to go until it can be fully and successfully integrated into healthcare systems nationwide. “We’ve just scratched the surface with the Precision Medicine Initiative, and it will be interesting to see what takes place in 2017 and beyond as we focus more on patient outcomes.”

rob halkes's insight:

Well established and short opinion on Precision medicine. Good to see the new journal too! Let's hope that this Obama initiative survives Trump's presidency! Why don't you share this to state your point?

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Could bedside TVs be used to give patients access to medical records?

Could bedside TVs be used to give patients access to medical records? | eHealth - Social Business in Health |
Televisions could be used to give instant access to medical notes and guidance, x-rays or scans, and dietary advice, explains Andrew Clark

There is good reason to be awed by NHS ambitions to gather the nation's medical data electronically into a digital Domesday Book, but also cause to pause.

Why isn't more priority being given to making the same information available electronically to patients, who might be said to have a prior claim, for free?

Evidence from a study in the US suggests that those on the receiving end of healthcare welcome having the access, and that clinical outcomes improve.

The Open Notes study involving 105 US doctors and published in 2012 found that 87% of patients allowed to look at their doctor's notes did so at least once. The vast majority, 78%, said it helped them stick to treatment.

Despite concerns from all sides, 99% of patients wanted the project to continue. Significantly, none of the doctors taking part have yet opted out.

Technology is available to give the same sort of access digitally in the UK, and, in the case of hospitals, it is usually right by the bed already.

rob halkes's insight:

Great to see these results of online information!It appears that just informed patients tend to adhere to their treatments better.
Now it is interesting to know, not only that they justified these informing procedures, but also how that has given them a better experience?

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Free The Data: APIs Boost Health Information Exchange - InformationWeek

Free The Data: APIs Boost Health Information Exchange - InformationWeek | eHealth - Social Business in Health |
New models promise to make sharing health information almost as simple as shopping on Amazon.

My last two articles had a common theme: freeing the data. We first looked at new approaches for patients and for providers. Of course, no matter how innovative the personal health records (PHRs) or electronic health records (EHRs) become, given the highly fragmented and specialized US healthcare system they still need to exchange data in a secure way that preserves privacy and trust. That is the goal of health information exchange (HIE).

HIE has been around for decades. Back in the mid-1970s, I tried (unsuccessfully) to create one in a rural county in South Carolina. From then until now, there have been nagging problems around the inherent lack of interoperability in commercial health IT systems; the lack of business incentives to share data; and the mismatch between the cost of HIT and its perceived (or real) financial benefits and to whom they accrue. We'll focus here on how interoperability might be achieved at an affordable cost.

The key HIE technical challenges are easily understood. Parts of a patient's clinical data will often be stored in many EHRs. For a patient with four, five, or more chronic diseases (these drive half of all Medicare costs) research shows that this will typically exceed 10 EHR implementations from multiple vendors! A conscientious provider seeing such a patient would want a comprehensive view of all of this care in order to save time collecting information that already exists, avoid duplicating tests and procedures that have already been done, and prevent mistakes from lack of information. ...

Historically, there have been two attempted solutions: 1) store everything centrally and, in essence, create a community record, or 2) keep the data at the source but build central indexes to patients and their medical documents and provide some kind of translation service to bridge differences in the way clinical data is represented across EHRs. This is the so-called hybrid exchange. ...

Thus achieving financial sustainability, in the absence of government or philanthropic subsidy, has proven too challenging ..

As a result, starting a few years ago a third approach began to gain traction. It's called the Internet! Actually, the proper term is federated exchange. Leave each patient's data where it is and use lighter-weight technologies to support exchange. ..

Read on !

Could this be the future of HIE? It's too early to be sure, but I wouldn't bet against it!

rob halkes's insight:

Indeed, in concspt these appear simple solutions. However as the cases from for instance Belgium and the Netherlands, each with different approaches, proove to be difficult. "Implementation" is the neam of the game.

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