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Christina's Considerations



The Nov/Dec 2011 issue of Healthcare Executive includes an article I wrote for the Satisfying Your Customers column, titled Engaging Staff with Social Media.  In the article I describe how successful leaders will prepare for the shifts occurring in the healthcare workplace; including the push for efficiency and new generations.  I also include a few examples of where social media is contributing to a more effective workplace in hospitals. 

Social media technologies are tools that can help increase customer, physician and employee satisfaction. I hope you will take the time to read the article and share your thoughts.

Another blog post that includes a few great workplace examples is list of 20 hospitals with inspiring social media strategies



I was interviewed for a recent article in Becker's Hospital Review that explores the common belief that older adults have more difficulty accepting and using technology.  It includes some great comments about "digital natives" and "digital immigrants" by the other interviewees.   

Speaking for myself, as a late Boomer, I can say that I certainly am a digital immigrant who has embraced technologies as I have found value to my work and life.  And, I believe that this applies to older adults in general.  There are differences in the generations and the oldest may need the most convincing and support, but it isn't that they can't incorporate technology into their daily life.

I remember older adults thinking it was a bit silly for people to carry around a cell phone.  But, once they began to realize value - they feel safer because they can call for help -- then older adults start using the technology just as anyone else.   If I'm correct, I also I believe this is how telephone adoption went.  It took a long time for it to catch on and for people to find value in the technology.  

Health IT is just one more advancement that needs to progress through the adoption cycle.




I've posted on the subject of volunteersyoung people working in hospitals and those considering a career in healthcare administration, previously.  However, this last week, I've been specifically researching Candy Stripers, who are sometimes referred to as Junior Volunteers.

Candy Stripers at Doctors Memorial Hospital, FL

I'd love to here your thoughts or stories about the youngest of our hospital workforce!  If you prefer something more personal, send me an email: Christina {at} cthielst {dot} com

I'm thinking I should also start researching the Pink Ladies, too!



The American College of Physicians has released an update to its Ethics Manual and new or expanded sections include, among others, confidentiality and electronic health records, health system catastrophes, boundaries and privacy, social media and online professionalism.  I really appreciate the manual and have pulled out a few key points based upon the topics I cover often on this blog.

  • Communication through email or other electronic means can supplement face-to-face encounters; however, it must be done under appropriate guidelines. Issuance of a prescription or other forms of treatment, based only on an online questionnaire or phone-based consultation, does not constitute an acceptable standard of care. (Exception: on-call situations) (pg 75)
  • Shifting principles guide the patient-physician relationship during catastrophes and physicians need to be prepared for decision making and the just delivery of healthcare. (pg 80)
  • Physicians who use online media, such as social networks, blogs, and video sites, should be aware of the potential to blur social and professional boundaries.  They therefore must be careful to extend standards for maintaining professional relationships and confidentiality from the the clinic to the online setting.  Physicians must remain cognizant of the privacy settings for secure messaging and recording of patient-physician interactions, as well as, online networks and media and should maintain a professional demeanor in accounts that could be viewed by patients or the public. (pg 81)


 All Changes to the Manual since the 2005 (fifth) edition

ACP Ethics Manual



Healthcare-associated infection data on all hospitals in Califorinia has been released by the California Department of Public Health (CDPH).  This means anyone can see the nosocomial infection rates of their local hospital by unit.  But, I urge some caution among consumers with comparing rates of different hospitals and units. Instead, this data should be used to prepare questions and for a discussion with your physician or the hospital.  Hospitals may be interested in using this data to benchmark themselves against other hospitals.

Healthcare-associated infections (HAIs) are infections that patients develop during the course of receiving healthcare treatment for other conditions. They can happen following treatment in healthcare facilities including hospitals as well as outpatient surgery centers, dialysis centers, long-term care facilities such as nursing homes, rehabilitation centers, and community clinics. They can also occur during the course of treatment at home. They can be caused by a wide variety of common and unusual bacteria, fungi, and viruses.

HAIs are the most common complication of hospital care, occurring in approximately one in every 20 patients. The following HAIs occurring in hospitalized patients are required to be reported to the CDPH by all California general acute care hospitals:

Data is also available on a couple of hospital practices that that contribute to a reduction in HAI rates and length-of-stay.





I participated in this morning's Gartner Worldwide IT Spending Forecast.  Gartner, the technology research giant, brought together some wonderful speakers who shared information that I feel is important to healthcare -- especially at this moment in time.  The issues will have major revenue implications for vendors (perhaps leading to service changes) and could delay current and planned IT initiatives (EHR adoption, HIE, etc) of healthcare organizations.

The floods in Thailand in October of 2011 severely impacted fabrication facilities and this has lead to a shortage of hard drives. It is predicted that it will take at least until the 3rd or 4th quarter of 2012 for the industry to get back to meeting demand.  There is some uncertainty about this timeline.

This means:

  • There will be storage and server component shortages.  Storage will not be cheap and providers will need to be efficient.
  • Virtualization (the cloud) may be a more affordable option.
  • We can expect longer lead times for delivery, backlogs and double ordering of products.
  • We can expect an increase in costs over the short term (re-assess those budget projections you made last year)

One lesson that comes from this situation is to have multiple geographic locations for the manufacturing of components to help prevent business disasters like this one.  In this case all of our (the world's) eggs (hard drives) are manufactured in one basket (Thailand).

PC and software spending is down due to the downturn in the economy.  But, there was one bit of good news that I pulled from the discussion on software.  Spending on software (tools) for collaboration is increasing.  Companies are investing in technologies that will help them stay competitive and this means tools that will help their employees collaborate will reduce the need to bring on additional people. 

Now, I've been seeing this in other industries and have started to see it trickle into healthcare.  With health reform upon us, I hope my friends in the hospital start thinking a little more out of the box and how they too can leverage collaborative tools (aka social media) to improve efficiency and effectiveness in the workplace.

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MedTech and Devices

Aging Services Technology Review


In the 9/26 issue of Bloomberg Businessweek, we learn of a company called Proteous Biomedical which is developing ingestible chips that can be embedded in pills, turning them into networked, digital drugs. The one-millimeter-square chip is activated by a patient's stomach fluids and sends a signal to a bandaid sized computer worn on the body. The computer uses Bluetooth technology to communicate with the patient's mobile phone, which alerts patients or their caregivers when they forget their medicine. The system has been tested in trials for drugs that treat heart failure, hypertension, and TB. Raisin-enabled drugs may hit the market as early as 2012. Additional information about Proteous Biomedical may be found at their website.


Contributing editor Peter Keating, in the September 2010 issue of Smart Money, has made a useful contribution to the examination of aging technology. In his article, Peter argues that emerging aging services products fall into three categories. First, devices such as medication optimizers and telehealth systems, which keep you healthy. Second, there is technology, such as wearable devices that automatically detect falls and alert family members, which promote safety. The third kind of senior technology, such as cell phones with large buttons and bright screens, are designed to make modern gadgets easier to use.

Source: Smart Money, September 2010, pp. 38-39


This announcement follows the formation of an alliance between the two companies in 2009, and makes good business sense, in my judgment. Many of the players in the aging technology arena are small and inadequately capitalized for the long run. Intel and GE have the deep pockets to stay the course and become THE dominant players.

The new venture will be based in Sacramento, and be owned equally by Intel and GE. Intel will contribute its assistive and remote health technologies, and GE Healthcare will contribute QuietCare, a remote monitoring system. The new company is expected to be operational by year-end.


The Academy of Senior Professionals at Eckerd College recently sponsored a conference entitled "Communications Technology for Telehealth and Telemedicine." Conference speakers included telehealth experts from Intel, Verizon, Polycom, and the VA region encompassing Florida and Puerto Rico. The range and depth of the presentations were remarkable. Although telemedicine has been around for some time, the technology in support of remote access medical services continues to evolve. The sophistication of diagnostic tools was particularly noteworthy. And, the VA is clearly a role model for telehealth utilization.


This firm's electronic minder system was recently featured in a New York Times article. The so-called Zume Life service includes two major technology components: an in-hand device, called a Zuri, and a web portal. The Zuri is a simple, small, handheld device that individuals use to get reminders and to record all health-related activities, events and status relevant to their own particular needs. The Zume Life web portal, for users and their caregivers, shows graphs, tables, and journals of the user’s health activities and status. The Zuri will cost about $200 when it is released in the spring. Users will also pay about $40 to $50 a month for Web services. A software version of the device that will run on an iPhone is also in the works.


A recent New York Times article notes that Microsoft's new online health data storage system called HealthVault lets users upload data directly to their account from about 50 devices, including many blood pressure and heart rate monitors, and blood glucose meters and weight scales. Owners of the account can then share data with their case manager, who could be tracking their response to a new medication, for example. This is good news. HealthVaults' utility to the consumer will increase significantly with the addition of devices which can upload clinical information to the storage system.
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MedTech and Devices

Health Informatics Blog



Web 2.0 was coined as a cool name for a conference about the state of the internet back in 2004. Kind of a play on the fact that software is released in ‘versions’ (1.1, 1.4,, etc, etc) whereas the web is clearly evolving and branching in a way that defies this kind of classification.

Web 2.0 draws an arbitrary line that says the current state of the web is significantly different now from how it was a few years ago.

There’s been a lot of talk about what Web 2.0 really means and what it doesn’t (here’s the official line from Tim O’Reilly who coined the term).

Here’s an anthropological take on Web 2.0:



Learn about heart anatomy and physiology through the power of song…

More medical videos.



This online app could be use for students creating their own learning projects or for staff to create course notes and resources for their students.



Revolution Health

Revolution Health is a new startup from Steve Case, former CEO of America Online and chairman of AOL Time Warner.

The website is an amalgamation of several startups purchased by Case and aims to offer an information portal about healthcare with medical tools and a database of doctors and clinics which users can rate.

Visiting the site, the main emphasis seems to be on the ability to rate your own physician. It also offers users blogs, forums and other ways of posting their opinions about health problems and health delivery.

The site has information from several insitutions including the Mayo Clinic, Cleveland Clinic and Harvard.

The site is only just launched so the effects of the social networking and user generated content has not kicked in yet. It will be interesting to see whether the site provides professional evidenced based advice on health issues or just ends up being a repository of anecdotal evidence generated from it’s users.



I’ve just been updating Doctors’ The site has news and discussion about PDAs, EMR and other gadgets that doctors use.

It’s also the host to the video tutorials that accompany the RSM Press book, “The Doctors’ PDA and Smartphone Handbook“.



Dr. Karim Keshavjee from McMaster University has written an article entitled ‘Oh no! Half of all current EMRs Fail’.

PDF of Full Article

Via Canadian EMR.

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News and Views
MedTech and Devices

eHealthNews.EU Portal / All News


EDMA, the European Diagnostic Manufacturers Association, and Eucomed, the European medical technology industry association, announced that their respective members have decided to join forces under the umbrella of a European industry federation.


EyeBrain, a company developing medical devices for the early diagnosis and monitoring of neurological diseases, announces that it is launching a new software version of its medical device, the EyeBrain Tracker.


eHealth Solutions with Potential
Changing demographics, an increase in the number of chronically ill patients and the advances in technology have brought healthcare systems to the limits of their performance. The key to sustainable healthcare lies in coordinating care delivery processes. Together with its partners, ICW strives to efficiently provide the needed IT-supported processes for providing the best possible level of care and at the highest possible level of cost efficiency:


iMDsoftiMDsoft®, a leader in clinical information systems, grew substantially during the last year. Over the past twelve months, the company has entered new territories, with first-time installations in Turkey, Sweden, and Austria. In total, iMDsoft was involved in over 45 critical care and anesthesia projects, and MetaVision went live in fifteen countries and ten languages.


eHealth Week 20127 - 9 May 2012, Copenhagen, Denmark.
eHealth Week 2012 brings together two main events: the High level eHealth conference co-organised by the European Commission and the Danish Presidency of the Council of the European Union, and WoHIT (World of Health IT Conference & Exhibition) organised by HIMSS Europe.


CetreaCetrea A/S, developer of innovative, research based hospital software, and Sonitor Technologies AS, the leading developer, manufacturer and supplier of a proprietary ultrasound Real Time Locating System (RTLS), has delivered the clinical logistics real time overview solution that is implemented at the Regional Hospital of Horsens in Denmark.

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MedTech and Devices



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I've just heard about the Information Technology and Communications in Health (ITCH) which will be held February 24 - 27, 2011, Inn at Laurel Point, Victoria, BC Canada.I'd not heard of this conference before but the current call for papers looks interesting.Health Informatics: International Perspectives is the working theme for the 2011 international conference. Health informatics is now a Rod


The report of the Prime Minister’s Commission on the Future of Nursing and Midwifery in England sets out the way forward for the future of the professions which was published yesterday, calls for the establishment of a "high-level group to determine how to build nursing and midwifery capacity to understand and influence the development and use of new technologies. It must consider how pre- and Rod


Mobile apps, services vendor rolls out a new healthcare division MobileHealthWatchFrom Bob Pyke Jr


21:04 Bob Pyke Jr


A new Health Informatics Specialist Workforce Development Strategy for England is being developed, based on research and intelligence gathered from across the NHS and other key stakeholder groups and organisations. The aim is to have a draft ready for consultation in May/June 2010. To help inform the content and to test out ideas and assumptions, two workshops are to take place aiming to bring Rod
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