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 | Scoop.it

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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Doctors Need to Be Where Their Patients Are: Online

Doctors Need to Be Where Their Patients Are: Online | eHealth - Social Business in Health | Scoop.it
If knowledge is power, then content (in proper context) is king. Why am I online blogging, pushing content through my website and even interacting on Facebook, Twitter, Google+, Pinterest and many other sites?  Because my patients are there. Increasingly, they are utilizing the Internet to self-diagnose; to look for “second opinions” from peers and friends; to research a physician, recommended treatment, or hospital; or to find the latest information on their disease.

Studies suggests that patients forget more than 50 percent of what they are told in the doctor’s office. Add to that misremembering or misinterpretation, and the information holes grow even larger. What happens to the holes when these individuals get home? Research shows that consumers trust the recommendations of peers or friends far above those of any advertisement. And where are people interacting with those friends? Where are they searching? In many instances, online. They are sharing useful information, and this includes health concerns, treatment protocols, and medications. When patients feel they can’t turn to their doctor for answers, pulling information from the Internet is an easy, efficient, and logical choice.

Medicine and healthcare are undergoing massive changes; more and more regulations and obligations eat into physicians’ clinic time. Reimbursements have dropped, and as a result many doctors have felt they needed to increase their appointment load and decrease the time they spend on each. For patients, that translates to less time with their physician, less learning, more questions, more doubt, and sadly, more fear. Their antidote is Google.

The root word for doctor is “docere,” or “to teach,” and our patients are making decisions based on what they read online. We as physicians have a moral obligation to be sure that the information they are receiving is accurate. If we do not have the time to teach our patients while they are in the clinic, we need to be present where they are to address their residual questions, hesitancy, and fears (often due to lack of knowledge), and also to aid them through their medical decision-making process. In short, we need to be active in producing or curating online medical content to aid our patients. 

Doctors often believe that they need to spend hours upon hours coming up with content; they believe there is too much risk involved in “tweeting” or putting a post on Facebook. Yet most studies show that physician content and social media interactions are perfectly appropriate. You know the rules – follow them. You do not need to be an active writer; you already answer the same questions day in and day out. Why not just sit and dictate the answer to those questions and post them online? Don’t want to hire a professional? Don’t. Tumblr, Posterous, and other such sites make it simple to set up a site for content in minutes. Still don’t want to create content? Fine – then share links to accurate, actionable, and useful information on Twitter or Facebook.

We are physicians; our job is to lead patients toward health. We owe it to them to be sure that the information they are reading is of the same quality as we would give in our office, or want to get if (or, rather, when) we looked in the mirror and saw a patient staring back.

Howard Luks, MD, is an orthopedic surgeon with offices in Westchester and Duchess Counties. He is an associate professor of Orthopedic Surgery at New York Medical College, and serves as chief of Sports Medicine and Arthroscopy at University Orthopedics, PC andWestchester Medical Center. Follow him on Twitter @hjluks.

If knowledge is power, then content (in proper context) is king. Why am I online blogging, pushing content through my website and even interacting on Facebook, Twitter, Google+, Pinterest and many ...
rob halkes's insight:

I don't need to say more, do I?

However, it may be best that the relationship between patients and doctors are approached from an equal perspective. It needs more than an attitude. But, eHealth applications seem to best suited for that.

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Definition of Health 2.0 and Medicine 2.0: A Systematic Review

Definition of Health 2.0 and Medicine 2.0: A Systematic Review | eHealth - Social Business in Health | Scoop.it
Definition of Health 2.0 and Medicine 2.0: A Systematic Review
ABSTRACT

Background: During the last decade, the Internet has become increasingly popular and is now an important part of our daily life. When new “Web 2.0” technologies are used in health care, the terms “Health 2.0" or "Medicine 2.0” may be used.
Objective: The objective was to identify unique definitions of Health 2.0/Medicine 2.0 and recurrent topics within the definitions.
Methods: A systematic literature review of electronic databases (PubMed, Scopus, CINAHL) and gray literature on the Internet using the search engines Google, Bing, and Yahoo was performed to find unique definitions of Health 2.0/Medicine 2.0. We assessed all literature, extracted unique definitions, and selected recurrent topics by using the constant comparison method.
Results: We found a total of 1937 articles, 533 in scientific databases and 1404 in the gray literature. We selected 46 unique definitions for further analysis and identified 7 main topics.
Conclusions: Health 2.0/Medicine 2.0 are still developing areas. Many articles concerning this subject were found, primarily on the Internet. However, there is still no general consensus regarding the definition of Health 2.0/Medicine 2.0. We hope that this study will contribute to building the concept of Health 2.0/Medicine 2.0 and facilitate discussion and further research.

(J Med Internet Res 2010;12(2):e18)

During the last decade, the Internet has become increasingly popular and now forms an important part of our daily life [1]. In the Netherlands, the Internet is even more popular than traditional media like television, radio, and newspapers [2]. Furthermore, the impact of the Internet and other technological developments on health care is expected to increase [3,4]. Patients are using search engines like Google and Bing to find health related information. In Google, five percent of all searches are health related [5]. Patients can express their feelings on weblogs and online forums [3], and patients and professionals can use the Internet to improve communication and the sharing of information on websites such as Curetogether [6] and the Dutch website, Artsennet [7] for medical professionals. The use of Internet or Web technology in health care is called eHealth [1,8].

In 2004 the term “Web 2.0” was introduced. O’Reilly defined Web 2.0 as “a set of economic, social, and technology trends that collectively form the basis for the next generation of the Internet, a more mature, distinctive medium characterized by user participation, openness, and network effects” [9]. Although there are different definitions, most have several aspects in common. Hansen defined Web 2.0 as “a term which refers to improved communication and collaboration between people via social networking” [10]. According to both definitions, the main difference between Web 1.0 (the first generation of the Internet) and Web 2.0 is interaction [11]. Web 1.0 was mostly unidirectional, whereas Web 2.0 allows the user to add information or content to the Web, thus creating interaction. This is why the amount of “user-generated content” has increased enormously [12]. Practical examples of user-generated content are online communities where users can participate and share content. Examples are YouTube, Flickr, Facebook, and microblogging such as Twitter. Twitter, for example, improves communication and the sharing of information among health care professionals [13]....

rob halkes's insight:

Review!

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Could Clinical Decision Support Empower Patients? -- InformationWeek

Could Clinical Decision Support Empower Patients? -- InformationWeek | eHealth - Social Business in Health | Scoop.it
It's time the medical establishment heeded the longstanding
advice of informatics pioneer Larry Weed and used "participatory" diagnostic methods, says editorial.

Neil Versel | March 22, 2013
Ideas long espoused by medical informatics pioneer Dr. Lawrence L. Weed but shunned or ignored by the medical establishment might find a perfect fit in a world of "participatory medicine,"suggests a well-known proponent of patients taking an active role in their own care in concert with healthcare professionals.

As he explained this month at the Healthcare Information and Management Systems Society (HIMSS) conference in New Orleans and in a 2011 book he co-authored with son Lincoln, Weed believes in "coupling" medical knowledge to specific patient problems with the aid of computers. Any attempt to practice medicine based on a physician's knowledge alone invites diagnosis error, according to Weed.

That opinion struck a chord with Terry Graedon, co-editor-in-chief of the Journal of Participatory Medicine. "Recent research reports have shown that misdiagnosis is an Achilles heel for the current practice of medicine," Graedon wrote in a commentary published this week.

[ A study suggests patients don't like it when doctors use computers to diagnose them. Read Clinical Decision Support A Turnoff For Patients, Says Study. ]

Indeed, the Journal of the American Medical Association's JAMA Internal Medicine just last month published a study showing that physicians missed a surprisingly high number of common diseases in ambulatory care. Although Graedon's article does not mention this study, it does raise similar themes.

Proper diagnosis, Graedon argued -- as Weed, creator of the problem-oriented medical record, has been doing for decades -- starts with a complete problem list. Then, a computer system couples problems to specific medical knowledge.

"If diagnosis begins with standardized data collection, doctors bring clinical judgment to bear at the final stage of diagnosis. Treatment should then be evidence-guided but individualized for the particular patient," Graedon wrote. "We trust that at this point the patient would make his or her preferences known and share in the decision," she added, bringing in the element of patient empowerment, because the Journal of Participatory Medicine is a publication of the Society of Participatory Medicine.

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rob halkes's insight:

As for Participatory medicine, shared decision making and perhaps co-creating patient experiences of therapies, we have to go a long road before protagosnists of care will find the right click in what to do and what not. Let innovators amongst them get togehter and try, try and try. It worth it! ;-)

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