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Dr Rachael Addicott, Senior Research Fellow at The King’s Fund, explains why a new approach towards primary care delivery is needed, and looks at how ‘family care networks’ – which entail new forms of commissioning, with GPs innovating in how care is delivered – can provide forms of care beyond what is currently available in general practices. 
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A new survey finds physician leaders in the pharmaceutical and biotech industry have more forceful personalities, typical of what you would see in business leaders, while leadership in hospitals tend to be more structured, thoughtful, deliberative and cautious. It's easy to assume physician leaders are all cut from the same cloth. After all, each likely needed the same dose of drive, determination and decision-making to be in the position they're in today — right?
Look and read further in the original blog!
rob halkes's insight:
Hey, Physicians do differ in relation wth the function they have. We knew that, do we, but is is insightful to learn what the differences are. Interesting. But do not take it for granted in the individual case! That's an error easily made.
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rob halkes's insight:
Insights! The majority og HCP's is now digitally native! Let's go on!
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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.
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Health care is very much „in transition”. Have a quick look at the trends in health care 2014 . Now, try to predict what the outcomes will be of all these well intended developments? Can this be prevented? As costs will drive change for the coming years, I guess not. Health care is fundamentally being transformed. Why? Because it has been righteously disrupted and it will take time before a new satisfactory system has emerged. Do we need to wait for that? No! We have to see how we can construe things in a more informed perspective. .. ..there is a sure direction to give that constitutes the basic principle for moving forward: both because it is immanent to all needed developments to better care, and because it creates the opportunity to developments in oversee-able steps of change. Every party can draw its own choice on this to design a proper blue print to their process of change. This principle directive is: Integrate, integrate, integrate. Integration in care is about the unification of both parties and activities, aided by technology, devices, information and medications, to create better care for health and its outcomes. There are three different kinds of integration. Each, open to start with. So, any party may pick and start its own game changer. Even any couple of parties as intended partners, may do so too. Choose the most easiest entry to your future development together and enjoy the ride! 1. Integration by Co-Operation2. Integration by Co-Creation. 3. Integration by “Experience Co-Creation”. ..
rob halkes's insight:
See what you think of this: Can it be done? Will different and several parties be as bold to set things into motion. We know there are. Why don't you?
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From "Telemedicoine and e-Health" Spanning Boundaries into Remote Communities: An Exploration of Experiences with Telehealth Chronic Disease Self-Management Programs in Rural Northern Ontario, CanadaTo cite this article: Published in Volume: 19 Issue 12: December 4, 2013 Abstract: Background: In rural and remote settings, providing education programs for chronic conditions can be challenging because of the limited access and availability of healthcare services. The purpose of this study was to explore the experiences of participants in a chronic disease self-management program via telehealth (tele-CDSMP) and to identify facilitators and barriers to inform future tele-CDSMP delivery models. Materials and Methods: Nineteen tele-CDSMP courses were delivered to 13 Northern Ontario (Canada) communities. Two types of group were delivered: (1) single telehealth site (one community formed a self-management group linked to program leaders via telehealth) and (2) multiple telehealth sites (several remote communities were linked to each other and program leaders via telehealth). Following the completion of the courses, participants were invited to partake in a focus group. Results: Overall, 44 people participated in the focus groups. Four main themes were identified by tele-CDSMP participants related to the overall experience of the program: (1) bridging the access gap, (2) importance of group dynamics, (3) importance of strong leaders, and (4) preference for extended session time. Key barriers were related to transportation, lack of session time, and access to Internet-based resources. The main facilitators were having strong program leaders, encouraging the development of group identity, and providing enough time to be comfortable with technology. Conclusions: Our findings suggest overall the tele-CDSMP was a positive experience for participants and that tele-CDSMPs are an effective option to increasing access to more geographically isolated communities. [Se download of article]
rob halkes's insight:
And again, ehealth promising great futures to health outcomes and costs, yet it is no panacea to current state of healthcare : it means work, experiment and development. We'll get there!
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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. 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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Live een congres volgen is dan wel erg 1.0, maar de deelnemers op het volgeboekte eHealth-congres twitterden zoveel dat #ehknmg op 9 februari landelijk een trending topic was. Het onderwerp leeft onder artsen. Digital doctoring is a hot issue in the Netherlands, twitter consults, on line therapy and digital are getting more popular each day. Health Insurance companies and health care delivery professionals join into these interests. President of the Dutch Doctors' associations, Arie van Nieuwenhuizen, opened the conference with the statement that "eHealth is now beyond being a hype." The conference agreed on the fact that eHealth still isn't that self evident part of common care. Structural reimbursement is relevant to that.
rob halkes's insight:
eHealth in NL beyond a hype. Great! See my short summary. There is a link to a videoreview. (All Dutch by the way ;-))
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According to a report over at 9to5Mac, Apple is developing a health app called Healthbook that will track steps taken, calories burned, and miles walked. The app will also helps users track blood pressure, hydration levels, heart rate, and other blood-related biometrics, including — possible — glucose levels. In addition to the tracking features, Healthbook will also reportedly help users remember to take their medications and may even integrate with the iPhone’s existing, built-in Reminders app. The report cites sources who describe the app as being modeled after Apple’s Passbook app, which is an app for storing loyalty cards and coupons. Like Passbook, Healthbook would be designed with an interface that resembles a stack of cards — each card representing a different health or fitness data point. 9to5Mac points out that many features and apps are developed for an upcoming iOS launch than the number that actually makes it into the final cut. While Healthbook may be under development at Apple, it still may never find its way to market. Rumors aside, Apple has been poaching engineering talent and senior employees from digital health companies over the course of the past year. So, it certainly has more than a passing interest in digital health. Most recently, MobiHealthNews broke the news that Apple had hired Michael O’Reilly, the former chief medical officer of Masimo Corporation, which specializes in pulse oximeters. At the very end of 2012 Masimo commercially launched an iPhone-enabled pulse oximeter called the iSpO2. Over the weekend The New York Times reported a few new scoops on Apple’s mobile health plans and its rumored iWatch project. Apple’s meeting in December with the FDA was focused on the subject of “mobile medical apps”, which is the term the FDA uses for those apps that need to be regulated as medical devices. “They are either trying to get the lay of the land for regulatory pathways with medical devices and apps and this was an initial meeting, or Apple has been trying to push something through the FDA for a while and they’ve had hangups,” Mark A. McAndrew, a partner with the law firm Taft Stettinius & Hollister, who first noticed the public notice about the Apple-FDA meeting, speculated in an interview with The New York Times.... [read on ]
rob halkes's insight:
Curious where this will bring us..
Richard Baxter's curator insight,
February 5, 2014 4:44 AM
Only a matter of time before Apple saw the potentail of health and big data combinations
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Survey shows UK doctors value medical journals and their websitesGPs in the UK rate journals, educational materials and events over literature, websites and reps from pharmaceutical companies when it comes to communicating information, according to the 2013 National Medical Readership Survey (MRS).NMRS 2013, which was run by the Joint Industry Committee of Medical Advertisers for Readership Surveys (JICMARS), also found that GPs are turning increasingly to digital media to fit their needs. The survey was intended to determine GPs' attitude to, and use of, print and digital media when it came to their work, with key findings including that speed is of the essence, with online sources increasingly the first port of call for quickly checking clinical information. Other key values of online for GPs included the ability to look for specific information. Printed publications still have their place, however, with the survey discovering that GPs value print read for 'longer, serendipitous and more leisurely reading', as well as to keep up-to-date with developments in clinical practice and for ongoing professional education. Regarding the medium for information, the survey found that GPs consider search engines the most useful source, following by medical educational materials. Social media for GPs was considered second least useful, ahead of pharmaceutical company and product websites. The survey also set to find out GP behaviour when it came to the types of information they look at, regardless of the medium. The top five information areas were those which fulfil surgery information needs: clinical information on diseases and conditions; information on drugs/treatments and prescribing; clinical guidelines; local protocols; and patient information. The 2013 survey included – for the first time – an online element. Combined with the established postal survey, this provided extensive data on the 'media landscape' as used by GPs, and the survey now delivers data on print readership, digital edition/ app usage and website usage.
rob halkes's insight:
Doctors are conveniency-oriented humans like we all are. It depends upon the context of their question or intention of the information search, whether they tend to print, digital or other channels. Surveys should start with this notion. Relating this condition to the responses to the question what sources of information they prefer, will inform us better.. ;-) See here, for an elaboration of context and search: "Informing doctors from standard messages to co-created meaning"
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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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A 3-stage model of patient-centered communication for addressing cancer patients’ emotional distress
Results
A three-stage, conceptual model for assisting clinicians to more effectively address the challenges of recognizing, exploring, and managing cancer patients’ emotional distress in the clinical encounter was developed. To enhance and enact recognition of patients’ emotions, clinicians can engage in mindfulness, self-situational awareness, active listening, and facilitative communication. To enact exploration, clinicians can acknowledge and validate emotions and provide empathy. Finally, clinicians can provide information empathetically, identify therapeutic resources, and give referrals and interventions as needed to help lessen patients’ emotional distress. ConclusionThis model serves as a framework for future research examining pathways that link clinicians’ emotional cue recognition to patient-centered responses exploring a patient's emotional distress to therapeutic actions that contribute to improved psychological and emotional health. Practical implicationsSpecific communicative and cognitive strategies are presented that can help clinicians better recognize a patient's emotional distress and respond in ways that have therapeutic value.
rob halkes's insight:
Guideline for physicians, great! (just a pity that the full publication needs to be heavily paid..)
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The use of social media by biopharma companies including data, insights and recommendations. by Richard Meyer
rob halkes's insight:
Well, this is one nuanced presentation by Richard Meyer, that I like. It gives background data and information with which you can evaluate the subject and reach your own conclusion. Don't know whether this coincides with Richard's conclusion, but as a reader, you don't need to bother, do you?
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Consumers are not limiting themselves to a few multifunction devices, but instead have increased the number of digital devices. Wearable technology, digital trust and increased usage of apps are all trends that bear watching in 2014.
Digital Consumer Tech Survey 2014
rob halkes's insight:
Interesting results of this Accenture survey: Consumers tend to reflect on what to do with what device. This will impact the provision of care. Maybe we have to differentiatie to what can best be done with what divice. See also the download of the report of the survey.
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One of Stephen Covey’s The 7 Habits of Highly Effective People is to Begin with the End in Mind.
rob halkes's insight:
Just a nice support stepwise help to get you into social media, also in health care and social media ;-)
Vincent Dickie's curator insight,
December 8, 2013 5:52 PM
"Begin with the end in mind" - so often overlooked in social media strategies. This is a great overview for putting a social media / marketing strategy together. 
Nicolas Fillat's curator insight,
January 3, 2014 8:59 AM
Pour reprendre les bases en ce début d'année
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20 Predictions in Medicine And Healthcare for 2014: From DIY Biotech to Mind-Controlled Exoskeletons
Every January, I publish my predictions for the upcoming year regarding medicine and healthcare. Usually, the majority of these predictions turn out to be valid later on, although I prefer calling them apparent trends rather than actual predictions. Here are my 20 points for 2014.
Just a recab from the blog: 1. Google Glass to be used in everyday healthcare 2. IBM Watson’s first commercial use by hospitals 3. Direct-to-consumer genomics to get new rules 4. 3D printing artificial limbs and biomaterials goes mainstream 5. The healthcare experience will be brought to the home 6. LEGO Mindstorms to be applied for DIY biotech 7. Home diagnostics to be the key trend 8. Wearable MRI technology 9. Optogenetics to be featured at major scientific journals 10. Bigger role of MOOCs as medical schools change approach about digital literacy 11. More connected digital healthcare devices and services 12. The first steps of Google Calico to be public 13. EEG controlled devices to appear 14. Exoskeletons will be featured worldwide 15. First really useful food scanners to be released 16. Gamifying the healthy lifestyle 17. Finally remote touch and simpler data input become possible 18. Nanotechnology to be included in the medical curriculum 19. Decision on newborn genome sequencing to be made 20. First results of Ray Kurzweil’s work at Google to be revealed
Read on the blog for descriptions of the trends.
rob halkes's insight:
Great overview. Nothing to add, Just curious to see some I didn't know. Question of course, will they all be "trends", already in 2014? It depends of course, but we'll see.
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Twitter in the healthcare industry: how are Tweets from healthcare providers helping patients and how are Tweets from patients helping providers? In the space of a few short years, Twitter has grown from several strands of inconsequential drivel to an information powerhouse. Originally conceived as a way to keep up to date with a small network of friends and family, the micro-blogging model, which sees the rapid exchange of quick-fire information, was soon recognised as an invaluable resource for professional organizations. An area that has benefited in particular from this format is the healthcare industry, where the output of short bursts of relevant news and developments can mean the difference between life and death. Social media sites such as Twitter now represent the largest source of healthcare discussion in the world. Just as celebrities have found Twitter a useful platform for communicating directly with fans, Tweets cut out the media coverage middleman when it comes to providing accurate news in real time from healthcare professionals. Read on to find out how medical authorities and industry experts are using twitter accounts to change the way healthcare is delivered.
.... Read on!
rob halkes's insight:
I can only strongly advice to read this, if you were in doubt about twitter's role in the heakth care industry! ;-)
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Definition of Health 2.0 and Medicine 2.0: A Systematic ReviewABSTRACT 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. (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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As a service employed by large numbers of technically savvy doctors, ZocDoc is in a special position to understand the attitudes, opinions, and efforts of providers on the cutting edge of healthcare technology. Today, we are proud to release the results of our first annual Digital Doctor Survey, which will reveal ongoing developments and new trends among these digitally-connected physicians. In the infographic below, we highlight some results from the 2013 survey. This includes insights into social media, online reviews, and practice management technology in digital doctors’ offices. Enjoy, and feel free to share within your networks! ...
rob halkes's insight:
Although it is an inspection worthy infographic, my comment to it, about the possibility to inspect the survey's methodological merits, has still not been responded too. I wonder why?
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Share This post is part of Altimeter’s Trends to Watch in 2014. To kick off the new year, here are seven trends I’m following closely in my research at Altimeter, inspired by my conversations with clients, keynote audiences, social media...
rob halkes's insight:
Certainly with som imagination to be recognized in health care markets, these disruptive trends.. What will 2014 bring and how will we see immanent changes?
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Research Report: The State of Social Business 2013: The Maturing of Social Media into Social Business Author: Brian Solis and Charlene Li, with Jessica Groopman, Jaimy Szymanski, and Christine Tran Publication Date: October 15, 2013 ltimeter Group conducts regular social business surveys to learn how social media is evolving within enterprise organizations. While we’ve included pieces of the data in previous reports, we are now making the survey results available to the public under a Creative Commons License as part of our Open Research. Some figures in this report also use survey results from 2010-2012 to provide year-over-year comparisons. We also include data and results from our newest survey that was conducted in Q3 2013. Analysis of our survey results reveal that social media is extending deeper into organizations and, at the same time, strategies are maturing. What was previously a series of initiatives driven by marketing and PR is now evolving into a social business movement that looks to scale and integrate social across the organization. The following report reveals how businesses are expanding social efforts and investments. As social approaches its first decade of enterprise integration, we still see experimentation in models and approach. There is no one way to become a social business. Instead, social businesses evolve through a series of stages that ultimately align social media strategies with business goals. Our hope is that the data shared in this report provides some perspective on where your company is today so that you can chart your own course for social business evolution.
rob halkes's insight:
Social business is extending into organisations indeed. Health care is deinfitely one of these. Although, respecting fundamental and specific characteristics of the business of care, it demands specific responses to change health care into a "social busines": the needed multidisciplinary nature of care, the demand for the active empowerment and self mangement of patients and the integration of therapy related activities into one, certainly to enable the right ourcomes for an individual case, but also to strive for cost effectiveness. Seeing all this in a perspective of "eHealth" might be the right starting point.
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Being a medical futurist means I work on bringing disruptive technologies to medicine & healthcare; assisting medical professionals and students in using these in an efficient and secure way; and educating e-patients about how to become equal partners with their caregivers. Based on what we see in other industries, this is going to be an exploding series of changes and while redesigning healthcare takes a lot of time and efforts, the best we can do is to prepare all stakeholders for what is coming next. That was the reason behind creating The Guide to the Future of Medicine white paper which you can download for free.
rob halkes's insight:
Want to know before you start? Here's the guide, but be sure to look at the book as well: Social media in clinical practice. Look out for my information on our "Thought Lab on eHealth" too ;-)
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http://pwc.to/1bAPmr1 Socio-economic impact of mHealth An assessment report for the European Union www.pwc.in June 2013 mHealth could save 99 billion EUR in healthcare costs in the European Union (EU) and add 93 billion EUR to the EU GDP in 2017 if its adoption is encouraged. EU healthcare systems face significant challenges that are creating concerns about the sustainability of healthcare delivery. The combination of increased prevalence of chronic disease and an ageing population that continues to grow is exacerbating the burden on healthcare delivery and costs across multiple EU member states.
rob halkes's insight:
There's no if to using mhealth nor why, it is just: when and how. MHealth, I woukd say: "ehealth" and mobile applications of it, will be able to save lots of money and creat klots of value!
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Run through the blog and get un update of social media use iun general
rob halkes's insight:
ALways good to notice the trends ;-)
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Health care providers should be making use of new mobile technologies that can facilitate higher quality of care in every patient interaction. A look at what's available now. FORTUNE -- Our country is facing a health care crisis. States are divided on Obamacare and Medicaid, and new legislation is not making any clear progress in increasing access to affordable health care. According to findings by the Urban Institute, nearly two out of every three uninsured low-income individuals — some 9.7 million people — who would have qualified for subsidized coverage under Obamacare might not receive it next year because their states have not expanded Medicaid. Also, according to a study by The Association of American Medical Colleges, we'll be facing a shortage of more than 90,000 doctors in the next five years. While there have been a lot of gloom and doom articles about these significant health care challenges we're grappling with, there has been surprisingly little talk about the incredible technology solutions that are being developed specifically to combat these issues. Legislation is slow, but technology is fast. And there are many ways that we can begin to increase access to affordable care with technology. A doctor's time is increasingly scarce and expensive. The only scalable, near-term solution is to enable physicians to be more efficient and manage more patients, while empowering them to improve the quality of care they can provide... MORE: Health apps don't save people, people do Health care providers should be making use of new mobile technologies that will empower physicians to become "coaches of care," and facilitate significantly higher quality of care in every patient interaction. Instead of people waiting for weeks or months to get a rushed appointment where they receive second rate care, health care facilities can support the wide adoption of technologies that will enable doctors to remotely connect, monitor, and interact with hundreds, even thousands of patients.
rob halkes's insight:
Good to see the attitude of wondering why care is not transfering fast to a new developments and improvement of care ... whereas there is so much for development of care instead of debating it's ever growing costs. Much more indeed is to be gained "with" the help of tehcnology. But be aware, it is not about just applying technology it is about rearranging care so as to benefit from the advantages. This, actually is the great burden to progression in care improvement: change!
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Integrated care, starting from Family care doctors and from that point making the chain to other care providers would be ideal. Still one of the most difficult developments to do..
You can do in steps. Do find Suggestions to this here!