Periodically I come upon discussions about whether pathologists should serve as "direct consultants" to patients as opposed to the normal indirect model. The latter, the norm, occurs when pathology and lab reports are sent to the test-ordering clinician who then communicates with the patient. I was therefore interested when I came across an article suggesting that radiologists perhaps should communicate directly with patients (see: Radiologists Are Reducing the Pain of Uncertainty). Below is an excerpt from the article:
Is there any reason that results are a private communication between a radiologist and referring physician? Is there any reason that patients end up waiting days, sometimes weeks, for their doctors to reveal what scans showed? Could radiologists actually talk to patients and give them results immediately?....[Committees convened by the RSNA] say the time is right — patients are more and more insistent on knowing how and why doctors make decisions about their care. And more and more medical centers and doctors’ offices are allowing patients to log on and see their medical records, which can include reports on scans. Neither [committee] is advocating laws requiring radiologists to tell patients their results. Instead they hope to make their case by demonstrating how some radiologists have successfully managed to communicate with patients and by letting radiologists know this is something patients want....But many people never consider asking to speak to a radiologist and many doctors seem to have no relationships with radiologists — they just hand patients [an order] for a scan and let them get it wherever they want. So change might take some doing. And some radiologists say talking directly to patients is anathema. A radiologist, despite an M.D. degree, cannot answer questions about drugs or surgery and without knowing the clinical history may not know if abnormalities are important. And would doctors even refer patients to a radiologist who blurts out a scan’s results? For now,...how quickly a patient gets the results of a scan, including M.R.I.s, PETs, CTs or ultrasounds, can be idiosyncratic and depend on the particular doctor and the particular patient.Yet patients want to hear from radiologists....[M]any radiologists remain sequestered in dark rooms, reading scans, sending reports to doctors within 24 hours, and letting the referring doctors decide how and when to talk to patients....[O]n the rare occasions when [patients ask to speak with radiologists], there is pushback from radiologists and referring physicians. Radiologists just do not have time to meet with many patients... [and] worry ...what happens when the news is bad.
I found one of the key points of this article somewhat odd. One of the arguments in favor of direct communication between radiologists and patients is that this would allow patients to receive imaging results faster. Note that the title includes a reference to "reducing the pain of uncertainty." Given today's electronic records, as soon as a radiologist completes and releases a report, it is immediately available to the clinician who ordered the study. The same applies to a report of a biopsy from a pathologist. The speed at which a patient is notified about the results is all about clinician priorities and goals. The author of this article apparently came to the same conclusion when she stated that it is up to the referring physician to "decide how and when to talk to the patient."
So, at least in my mind, the major advantage that a patient would gain by talking directly to a radiologist or pathologist about a report would be acquiring knowledge that these diagnosticians uniquely possess. In the case of the radiologist and discussing a lesion in the lung, this would boil down to a discussion of the differential diagnosis of masses in lung images. In the case of the pathologist, it would be perhaps a discussion of the pathobiology of lung tumors and what a malignant versus a benign lesion would look like under the microscope. I think that an occasional patient would benefit from such a discussion but probably not the majority.
I was referring above mainly to a surgical pathologist. I think that perhaps a more extended and useful discussion could occur between a patient undergoing a prolonged workup for a rare or obscure disease and a clinical pathologist who was well versed in, say, molecular pathology or cancer genomics. In such a case, a direct conversation could be very helpful for an engaged patient.
I’d recently heard a practice manager talking about their EHR and Practice Management system. We talked about the EHR they’d selected and what they thought of the setup, and then I asked which practice management (PM) system they were using. They responded that they’d been using the same PM system for so long, they didn’t have any desire to change it. Then they dropped the bomb:
“There are a lot of things we hate about our PM system, but we kind of look at it as the devil we know.”
I see this happen really often when it comes to EHR and PM systems. In fact, it happens everywhere in the world of technology. Sometimes we don’t have any desire to change because we know the system we have and it works. Does it have its pain points? Yes. Do they drive us nuts? Yes! But at least we know about them and know how to deal with them.
There’s a real fear by many to switch to a new software where they have to learn about new “devils” for which they don’t know how to handle. I’m often reminded of the concept that “change isn’t always better.” So, in many situations, it’s better to not change. Maybe what you have isn’t very good, but if you’re not careful you could change to something even worse. That’s a real healthy fear.
That said, the fear can go too far. I’m reminded of when I had my first Android phone. I’d gone pretty cheap and gotten this really inexpensive phone. It worked, but was really slow. Plus, the battery barely lasted and it had plenty of devils I had to deal with whenever I used it. Luckily, I didn’t use it that much since I mostly work from home. However, when I was stuck in the depths of a massive exhibit hall at HIMSS and couldn’t get connectivity or I was waiting on the phone to do something, it was absolutely annoying.
The devils of that phone finally got to me and I upgraded to the Samsung S3. It was night and day difference. I must admit that I really didn’t know what I was missing. In many ways that was good, because it helped me to appreciate the upgrade. However, I’d kind of gotten complacent and was fine dealing with the “devils” I knew. (Side Note: Thanks to a few cracked screens from my wife and children, I’m now on the Samsung S5 and it’s awesome. The battery life itself is so compelling.)
Unfortunately, there’s no science to when to stick with the devils you know and when to upgrade. Without incentives, penalties or other regulations, there’s almost never a financial justification to upgrade software. It’s almost always cheaper to limp along with the old technology. However, there’s an extremely important sanity portion of the upgrade decision that is key.
I’ve personally found the time to upgrade and switch is when you know that the upgrade will solve the “sanity” issues you’re experiencing. If the upgrade won’t solve those issues, then it’s better to stick with the devil you know.
I’ve been a bit remiss the last few days, in that the latest Health Wonk Review came out Thursday, and I’m just getting around to sharing it now.( Blog carnivals work best when contributors link back to the compilation.) But, better late than never, right?
In that spirit, and in the spirit of Thanksgiving, I invite you to check out Health Wonk Review: The Turkey Edition, hosted by David Harlow on his HealthBlawg. The big stories this time around are all about insurance coverage under the Patient Protection and Affordable Care Act, a.k.a., Obamacare, but there is also an interesting posts about “wrist slaps” given to pharmaceutical executives for allegedly violating drug-marketing laws.
My post at Forbes.com about the American Medical Association belatedly but predictably fighting the impending Medicare penalties for not meeting Meaningful Use makes the cut. I’m particularly proud of the line, “Ruthlessly Defending the Status Quo Since 1847. :)
Check it out, and for those of us here in the United States, have a happy Thanksgiving. I’ll see you after the long weekend.
Just days before the clock was to run out on hospitals, including Critical Access Hospitals, hoping to attest to Meaningful Use of EHRs for 2014, the Centers for Medicare and Medicaid Services has pushed back the attestation deadline by a month, until Dec. 31.
In an announcement posted yesterday on the CMS Meaningful Use registration and attestation login page, CMS said: “CMS is extending the deadline for Eligible Hospitals and Critical Access Hospitals (CAHs) to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year from 11:59 pm EST on November 30, 2014 to 11:59 pm EST on December 31, 2014.”
Just don’t expect to do so online during a short period in a couple of weeks, as CMS says the site will be down for maintenance from Friday, Dec. 12 at 10 a.m. EST to Saturday, Dec. 13 at 12:30 p.m. EST. CMS also says people “may experience intermittent connectivity” Nov. 30 between 12:01 and 5 a.m. EST.
This extension “will allow more time for hospitals to submit their meaningful use data and receive an incentive payment for the 2014 program year, as well as avoid the 2016 Medicare payment adjustment,” CMS says.
A year without negative or challenging headlines would be an unreal one. Life always has challenges, just as health IT does. Here are just a few sample headlines of the challenges with electronic health records (EHRs), interoperability, and patient engagement”
Just Google “EHR” or “health IT” or a related term and add “challenge 2014″ to it and you will find many articles highlighting the challenges being taken on and worked through. Now do the same search with “success 2014″ at the end and you will find very few relevant articles.
During this season of gratitude and giving, let’s share our gratitude by giving thanks for what health IT and healthcare professionals are doing every day to make our health system better. Join our annual campaign:
Let’s come together and celebrate the hard work done by the many (many) dedicated health IT and healthcare professionals, sharing our thanks and gratitude.
Social media like Facebook and Twitter are driving major changes in industry sectors like sales and marketing. It turns out that companies will now pay big money to celebrities for a mention in a tweet. The "currency of this realm," which is to say one's popularity on a social media site, is calibrated by the number of friends or followers one is able to attract. However, it turns out that these numbers can be manipulated by the use of bots (see: Social Media Bots Offer Phony Friends and Real Profit). Below are some details:
[A] giant pyramid scheme has emerged on social media, where fake friends now command real money. Here’s how the pyramid works: With minimal effort, I downloaded a piece of software called Twitter Supremacy. For $50 for a six-month license, the software...lets me fabricate an unlimited number of friends. Furthermore, I can program these fake accounts to tweet, retweet and follow others automatically, as if they were living, breathing users.....Who pays for these services? The bot creator said that his clients include well-known celebrities and brands, along with everyday people who want a social media ego boost....Consider, for example, that a celebrity like Kim Kardashian, who has 25 million Twitter followers, has been paid $10,000 to tweet about ShoeDazzle. Or that Charlie Sheen, who has 11 million followers, was reportedly paid $50,000 to tweet about internships.com. What if many of their followers are fake? Numerous reports have found that celebrities, politicians and companies often buy fake followers to enhance their perceived importance online.....The practice is so widespread that StatusPeople, a social media management company in London, has a web tool called the Fake Follower Check that it says can tell how many fake followers a person has. According to that tool, 6 percent of Ms. Kardashian’s followers are fake, as are 12 percent of Mr. Sheen’s.
For those of you like myself who don't sample Kim Kardashian's Twitter page often, here is a link to it. She is listed as having 25.6M followers. Prepare yourself for the extreme use of exclamation points in her tweets. Her's an example: You guys are gonna die!!!!!!! Mocking Jay was soooooooo good!!!!!! Putting aside the fact that some six per cent of her followers may be phony, the fact remains that some 25M are probably real people who seem to be very interested in her opinions about various issues. Even more important is the fact that she is reported to having been paid $10,000 for posting tweets of which perhaps a third of the characters may be exclamation points.
The relevance of all of this for the readership of Lab Soft News is that social media are also being used to discuss serious medical issues. I have blogged previously about the relationship between social medical and pharmaceutical companies (see: Limitations Placed on Big Pharma Facebook Pages). Here's an update on this topic: FDA Readies Social Media Rules For Big Pharma. Over the last six months, the FDA has released three draft guidance documents about this issue. The FDA sponsored a "Social Media Draft Guidance Webinar” last July. The slides for a PDF file of the webinar can be viewed here.
The FDA webinar slides linked to above are couched in dense bureaucratic and legal language. However, one point that comes through loud and clear is the references to the use of "third parties" by pharma companies to communicate on social media. The pharmaceutical industry has a history of using third parties such as "disease foundations" and their web sites for marketing their drugs. Some of these non-profit disease foundations are supported by large pharma grants so that they function as extensions and mouthpieces for drugs and companies. I have blogged about web sites with booby traps (see: Identifying Risky and Biased Medical Web Sites). Here is a quote from that note:
Jill of All Trades MD has posted a note about how to identify medical "booby traps" on the web. By this I mean web sites and blogs providing medical advice that is skewed, unscrupulous, or designed to sell you some product like vitamins. I am also bothered by "disease foundations" that sponsor what appear to be unbiased web sites but which receive most of their funding from pharmaceutical companies and medical device and may exhibit favoritism in this regard.
The hottest area in web search is image search and analysis. Needless to say, this will be a very important component of pathology informatics because of the evolving role of digital imaging in surgical pathology (see: "Eminence-Based" Surgical Pathology and the Digital Pathology Department; Image Analysis Using an iPhone Camera; Comparisons with Digital Pathology). Google scientists have achieved a breakthrough in image description using neural networks (see: Google’s Brain-Inspired Software Describes What It Sees in Complex Images). Below is an excerpt from the article describing the work:
Researchers at Google have created software that can use complete sentences to accurately describe scenes shown in photos....When shown a photo of a game of ultimate Frisbee, for example, the software responded with the description “A group of young people playing a game of frisbee.” The software can even count, giving answers such as “Two pizzas sitting on top of a stove top oven.”....Google’s researchers created the software through a kind of digital brain surgery, plugging together two neural networks developed separately for different tasks. One network had been trained to process images into a mathematical representation of their contents, in preparation for identifying objects. The other had been trained to generate full English sentences as part of automated translation software. When the networks are combined, the first can “look” at an image and then feed the mathematical description of what it “sees” into the second, which uses that information to generate a human-readable sentence. The combined network was trained to generate more accurate descriptions by showing it tens of thousands of images with descriptions written by humans....After that training process, the software was set loose on several large data sets of images from Flickr and other sources and asked to describe them. The accuracy of its descriptions was then judged with an automated test used to benchmark computer-vision software. Google’s software posted scores in the 60s on a 100-point scale. Humans doing the test typically score in 70s....That result suggests Google is far ahead of other researchers working to create scene-describing software.
When we get to the point of widely implemented digital pathology and image search, the surgical pathologist will never be redundant. Rather he or she will be empowered to operate more efficiently. We can draw an analogy between the current use of digital imaging in cytopathology and hematopathology. Here's a quote from an article about digital imaging in hematology (see: Digital imaging in hematology):
Digital imaging of Romanovsky-stained blood films can improve the work environment and alleviate some of the burdens associated with performing a WBC differential. With properly prepared and well-stained blood films, imaging technology can locate WBCs, capture images of the cells, perform a preliminary classification of cell type, and then display those images on a monitor. The advantages of this approach are immediately evident, since the technologist is freed from preparing slides and locating cells and can manipulate cells on the monitor to confirm or reclassify the identity of 100 (or more) WBCs. Metaphorically, the technologist becomes the editor, rather than having to author the book.
I think that we will see the following scenario evolving in the deployment of digital pathology in surgical pathology. Stained glass slides will undergo whole slide imaging and then a step in which the images are compared to those in an image archive seeking comparable cases. The surgical pathologist reading the case will then be directed to abnormal areas the slides with suggestions about what such cases have been diagnosed as previously. This is what my colleague Dr. Ulysses Balis has referred to as assisted, directed review. It may be the case that biopsies deemed totally normal by the search and analysis algorithms may be automatically signed out which is now the SOP for WBC differentials. However, any suggestion of abnormality in a slide will automatically require the attention of a pathologist.
Only readers of this site could enjoy this pharmacy sign. Thanks to HIPAA One for sharing the picture with me. Have a great weekend everyone! Stay Warm!
Maybe the pharmacy thought that HIPPA with two P’s stood for Patient Privacy. Of course, a quick search through posts on my site turn up 18 posts with HIPPA. So, this might be the pot calling the kettle black. I just enjoy the humor of humanity.
Well I thought we were trying to crack down on hydrocodone abuse and maybe the deterrent properties are the key here. In the last couple of years I seem to remember more of these types of products being approved or maybe I’m just imagining things? It comes from Purdue labs, one of the long time manufacturers of hydrocodone. Granted we need pain killers for short term after surgeries, etc. and some folks with long term use needed to where there’s not any other alternatives so they can’t go away. BD
Hysingla ER has properties that are expected to reduce, but not totally prevent, abuse of the drug when chewed and then taken orally, or crushed and snorted or injected. The tablet is difficult to crush, break or dissolve. It also forms a viscous hydrogel (thick gel) and cannot be easily prepared for injection. The FDA has determined that the physical and chemical properties of Hysingla ER are expected to make abuse by these routes difficult. However, abuse of Hysingla ER by these routes is still possible. It is important to note that taking too much Hysingla ER, whether by intentional abuse or by accident, can cause an overdose that may result in death.
The following is a guest blog post by Mark Fulford, Partner in LBMC’s Security & Risk Services practice group.
The next round of Office for Civil Rights (OCR) audits are barreling down upon us, and many healthcare providers, clearing houses and business associates—even ones that think they’re prepared—could be in for an unpleasant surprise. If the 2012 round of OCR audits is any indication, the upcoming audits will most likely reveal that the healthcare industry at large is still struggling to figure out how to implement a compliant security strategy.
Granted, HIPAA regulations are not always as prescriptive as some might like. By design, HIPAA incorporates a degree of flexibility, leaving covered entities and business associates to make decisions about their own approach to compliance based on size, budget, and the risks that are unique to their operations.
But the first round of OCR audits indicated that many healthcare organizations had not even taken the first step in initiating a security compliance strategy—two-thirds of the covered entities had not performed a complete and accurate risk assessment to determine areas of vulnerability and exposure. Apparently, these entities were not necessarily unclear on HIPAA regulations; they simply had not yet made a serious effort to comply.
Out of the 115 entities audited, only 13 had no findings or observations (11%). This time around, the expectation will be that covered entities and business associates will have taken note of the 2012 audit findings, and that the effort to comply will be much improved.
All covered entities and business associates may be subject to an OCR audit. If you have not yet conducted an organizational risk assessment, now would be the time to do so. The OCR provides guidelines, and you can also reference the Office of the National Coordinator for Health Information Technology (ONC) and standards organizations like the National Institute of Standards and Technology (NIST). Additionally, the OCR has released an Audit Program Protocol to help you better prepare.
Five Key Areas to Address for OCR Audit Preparation
Based on our experience in the healthcare industry and consistent with the 2012 OCR Audit findings and observations, here’s how you can prepare for the upcoming OCR audits:
While OCR audits give the OCR an opportunity to step up enforcement of HIPAA rules, anyone can register a complaint against you at any time. Thorough preparation for the upcoming OCR audits not only ensures that you will pass one if you are selected, it also protects you from breach, patient complaints, and general loss of public trust and good will.
About Mark Fulford
Mark Fulford is a Partner in LBMC’s Security & Risk Services practice group. He has over 20 years of experience in information systems management, IT auditing, and security. Marks focuses on risk assessments and information systems auditing engagements including SOC reporting in the healthcare sector. He is a Certified Information Systems Auditor (CISA) and Certified Information Systems Security Professional (CISSP). LBMC is a top 50 Accounting & Consulting firm based in Brentwood, Tennessee.
I’m excited to tell you that we’ve officially announced the 2nd Annual Health IT Marketing and PR Conference happening May 7-8, 2015 in Las Vegas. We’ll do a full post in the future describing all the details, or you can check out the HITMC conference website for many of the details as well. It’s going to be the greatest gathering of healthcare marketing and PR executives that’s ever been done. People’s response to the first event has been amazing and I believe what we have planned for the second year will be even better. We hope we’ll see you there.
Here at EMR and HIPAA, we continue to grow and reach amazing new milestones. We just passed 10 Million pageviews on just EMR and HIPAA. We’ve done 2142 blog posts and you’ve contributed 9598 comments during that same time. Plus, I’m really excited that the Healthcare Scene blog network has over 29,500 Healthcare Scene email subscribers. I appreciate every reader that trusts us to provide thought leadership on the healthcare IT industry. We’ll keep doing everything we can to provide you value every day.
As part of our regular content, we’ve been working really hard on a number of amazing sponsored blog post series. They’ve been very well received by readers. I previously highlighted the content series that have been sponsored by Medical Management Corporation of America and The Breakaway Group. I’m sure that many of you have also enjoyed the recently started Cost Effective EHR Workflow Series that’s being sponsored by ClinicSpectrum. I’m looking forward to the amazing content these sponsored series provide readers.
Since our last post recognizing companies who support the work we do, we’ve had all of these great companies renew their sponsorships:
Ambir – Advertising since 1/2010
Cerner – Advertising since 9/2011
Canon – Advertising since 10/2012
gMed – Advertising since 8/2013
Colocation America – Advertising since 10/2013
Modernizing Medicine – Advertising since 1/2014
I’m extremely proud of those advertisers who’ve supported us for such a long time. Hard for me to believe that Ambir, for example, is about to reach their 5 year mark advertising on EMR and HIPAA.
A big thanks also goes out to our new sponsors. If you enjoy the content we create, take a minute to check out these companies and see if they can help you in your business:
HIPAA Secure Now! – I’ve written regularly about the need to do a proper HIPAA Risk Assessment in order to avoid any HIPAA penalties and to meet the meaningful use requirements. While you can do the HIPAA risk assessment in house, there’s some real value in having someone outside your organization being the one doing the HIPAA Risk Assessment. Avoids a conflict of interest. If you’re looking for someone to help you with your MU risk assessment, check out what HIPAA Secure Now has to offer.
Blue Horseshoe Network – I think their ad says it all. “Just Call Justina” if you need support for your EHR Go-Live, EHR Training or EHR optimization support. I’ve had a chance to interact with Justina myself and she’s got a lot of energy and passion for the work she does. Check out what Justina and Blue Horseshoe Network can do to help you in your EHR efforts.
Canon – You’ll see that Canon was listed in our renewing advertisers, but I wanted to highlight them here as well since they just started a big email sponsorship campaign with us. Canon is doing a lot of work to bring their fully integrated scanning solutions to healthcare organizations. We appreciate their support of our site and now our email lists as well.
You can get more details on how to get your company added to this list of EMR and HIPAA supporters. Just drop us a note on our contact us page. We’re happy to talk with you and your company about our sponsored content, display ads, email marketing, and webinar options. I think you’ll be impressed by the fully integrated email, SEO, display, and social marketing campaigns we provide.
I reported recently that the Cleveland Clinic, an Epic EHR client, was developing its own EHR interconnectivity solution (see: "Don't Tell Judy Faulkner," Cleveland Clinic CEO Cosgrove Cautions Audience). At a health innovation conference, CEO Cosgrove commented "that EHR interconnectivity will be happening across the country in three or four years'" but cautioned the audience "not tell the Epic CEO Judy Faulkner" about this trend. Now comes news that Geisinger Health System, a Cerner client, is also working on an interconnectivity solution (see: Interoperability: Now Geisinger has an app for that). Details are provided in the excerpt below:
Geisinger Health System and xG Health Solutions, a company founded by Geisinger, have connected a software app to an electronic health record by employing a new draft standard developed by international standards organization Health Level Seven. Geisinger developed a rheumatology app to interact with its Epic EHR. Now, by using the new HL7 draft standards, Geisinger and xG Health Solutions have successfully exchanged clinical data in real-time within the Cerner EHR framework. Geisinger and xG Health Solutions anticipate enabling apps to work in a similar fashion with all EHRs. This new "app approach" to augmenting EHR functionality has the potential to transform the delivery of healthcare by giving providers access to analyses of information that resides outside and/or inside the EHR, as well as decision support, regardless of the underlying EHR platform, Geisinger officials say in announcing the feat....Geisinger expects to make apps like these available to other healthcare systems through xG Health Solutions, founded by Geisinger in 2013 to commercialize Geisinger innovations. Geisinger and xG Health Solutions used an approach developed with grant support from the Department of Health and Human Services' Office of the National Coordinator's Strategic Healthcare IT Advanced Research Projects, known as SHARP, specifically the open-source Substitutable Medical Apps, Reusable Technologies, or SMART Platform. This Web-based interoperable container and the corresponding HL-7 Fast Healthcare Interoperability Resources, or FHIR, interface can exchange information in real-time with any SMART-on-FHIR-enabled EHR."
Epic has been dragging its feet with regard to interconnectivity of its product with EHRs from other vendors but not among its own client base. In my opinion, the company has been pursuing this strategy both to provide a valued feature to its own clients and also to promote its software as a de facto interconnectivity standard. Such a goal was not inconceivable given Epic's popularity among large hospitals. What Epic apparently did not bank on was that the Cleveland Clinic was willing and able to enter the software market with its own solution. Geisinger, through its IT company xG Health Solutions, was following a similar path with regard to the Cerner EHR. Look for Epic perhaps to soften its position on interconnectivity with foreign systems in light of these changed circumstances. I don't think that it will relish the scenario of competing with one of its own major clients in software sales.
The following question was posed on Twitter at the Healthcare Leader (#hcldr) chat:
“Over the holidays, can we ‘talk turkey‘ about health with family and friends?”
This post happened to be scheduled right before the holidays, and I had been compiling a list of new consumer health tech that could make a difference – not just for ourselves – but in the lives of our family members and loved ones in the year ahead. The list was not meant to be commercial or comprehensive. But how could we better support each other in health? What technologies could help prevent the most chronic conditions?
At a recent family gathering, we had been discussing our health, and spontaneously decided to check our blood pressure and glucose readings. Although most of us did not have high blood pressure, and were not in the range of prediabetes, it led to a lively discussion.
Early adopters enjoy the newest technologies and bold predictions, like those from futurists at Exponential Med (#xMed). The skeptics dismiss innovations like wearable tech as just a fad, or just for fitness buffs and “Quantified Selfers.” Others see the implications of new health tech as threats to privacy – like collecting and sharing data with employers and insurance companies.
Some innovations do not take off with consumers, like Google Glass, but fare better in B2B applications, according to Dr. Rafael Grossmann. His foresight for Google Glass in medicine is still one of the best use cases for the technology.
So far, Apple has pushed back the release of its new Watch. But in 2015, a number of smartwatches will have the ability to continuously collect biometric data. We can expect precise readings for heart rate, blood flow, respiration, and glucose all in one device, like the Samsung Simband. No one has a system for sharing this data “between” people yet.
New Consumer Health Tech – The Gift of Health
Wearables and health apps are great for fitness and chronic disease, but now we can use this technology for everyone to prevent chronic conditions. New tools make information accessible to the consumer that previously had only been available when seeing a doctor.
Ignite a conversation about health with family as smart consumers, and maybe they can avoid becoming patients of chronic disease.
Heart disease is the leading cause of death in the United States. AliveCor lets you manage heart health by recording your own electrocardiogram, and immediately relaying if atrial fibrillation is detected. AliveCor can now also track medications, symptoms (palpitations and shortness of breath), habits (caffeine or alcohol consumption), and activities (exercise and sleep) while using the monitor and app. (AliveCor’s inventor, Dr. David Albert, is also an interesting person to follow on Twitter!)
Hypertension affects one in three adults in the U.S. But the “white coat effect” of high blood pressure readings is very real.
“Researchers concluded that repeated measurements taken at home may help give a more accurate picture of blood pressure control than a single reading in a doctor’s office.”
Researchers hope to learn more about the disease and correlations as people track their own blood pressure more regularly. Treating signs of high blood pressure early can make all the difference. Why not make it a habit to take family blood pressure readings?
Seasonal Affective Disorder, characterized by fall/winter major depression and spring/summer remission, affects up to one in ten people in some northern states. But SAD can even be found in Florida.
Interdisciplinary research is needed to advance scientific knowledge about SAD. Solar-powered SunSprite tracks sunlight impact and measures your UV exposure.
All signs point to Home-as-a-Platform. Amazon Echo just launched, and is already attracting a lot of controversy, not unlike the introduction of Google Glass. However, Echo could make life easier for the elderly and disabled with its voice recognition technology that is touted as superior to Apple’s Siri.
Training your brain can help you reduce stress, improve focus, and enjoy a better quality of life. Why not practice mindfulness with the whole family? The benefits of mindfulness have been proven through medical research, and can even change the brain after only eight weeks of practice.
MUSE cites research that 20 minutes of focused attention training for only 3 days in a row can measurably improve mood, as well as reduce pain, anxiety, and heart rate.
After the holiday dinner, gather everyone for a walk, and talk about how you can improve your family health and fitness. Get inspired, by the stories about those who face real challenges, yet still manage to get out there and run.
I run to express the gratitude for the life that I have. – Alicia Shay
I have never seen anything like this and I’m not happy with either party. I can understand the battle a bit though as the Democratic Dupers have sucked in so much “junk science” that it has irritated the other side to be the party of no with almost any science. I get irritated with what I called the Sebelius Syndrome as you can’t find anyone that was more of a repeated “public duper”, not once but over and over and I can’t figure out for the life of me where in the heck she came up with some of her rationalizations and actions. She had some smart people and and dupers working for her, but I must say the dupers won, either that or she listened to neither and was left to her own duped perceptions.
Folks in tech used to just sit and roll at some of what she said and it wasn’t for the fact that it was really messing with some big systems, it might have actually been funny. One of the best ones though is the letter sent out telling all hospitals and they were billing liars, along with software vendors in the Health IT business. In that case she even went so far as to duped Holder into signing the letter too:)
What’s funny about this too is that just a couple months ago CMS found an insurer that billed up $70 billion in “said fraud” using a risk fiddler and soaked them over 5 years so all the billing fraud inquiries and investigations couldn’t even touch this number, so we had a case of Algo Duping deluxe, and again those wacky perceptions we had to listen for a number of years:)
So there’s the Democratic Dupers who believe all the stats and formulas insurers tell them, while they algorithmically cash in. Health insurers have armies of Quants that really know how to work “the virtual” value world and the dupers never questioned it. I go back to my first sales manager I had when I was young who told me “throw numbers at them and you’ll get your sale” and that what we have with the Democrats here. Even the White House aggravated me with using junk science numbers with Climate Control and I have no problem with it but it made me mad to see duper stats that nobody can predict, insulted my intelligence but I wrote it off as that came from the Democratic Dupers. I don’t mean any disrespect here but damn this stuff is getting thick and you sit and wonder how much more will they dupe on in? Don’t put 2300 less hospitalizations will take place with one year of Climate Control as nobody and I mean me or anyone else can predict that because we have this little element called “variables” out there.
The best I could figure on that one is that the geeks at the White House were mirroring what we see in the news every day and were following a dupe pattern as everyone could be duped right?
Here’s another matter, does either party realize “the machines” are running the Affordable Care Act? From what I read, and it might be part media too, they don’t get it and still think a big shout down or another “he said she said” deal in the news is going to make a difference?
So let’s cut the crap here and get the Democrats out of their virtual worlds of sucking any set of numbers you toss at them and maybe the GOP won’t be so mad all the time and hang way at the other side? You think? Again I can see the aggravation here as I’m a Democrat and I get mad a their dupes! It’s stupid and I know better and there’s folks out there a lot smarter than me that read this stuff too, so stop the dupes! The GOP can stop being party of the “NO”. The more the Democrats dupe on us, the madder the GOP get and nothing happens.
We have healthcare models at CMS failing right and left and need to be redone and it’s all those over quantitated formulas that United Healthcare mentored over there for years and they don’t work anymore, just like the quantitative formulas for hedge funds, they’re not working anymore and everyone’s on this quest for some magical algorithms and they won’t find them to make big money like they used to.
We have way too many folks confusing virtual world values with the real world, so much to the point to where doctors are just about choked at the neck with all of this and nobody’s getting any better care but the Health IT bills are going up. Some of that needed to be weeded out so we have “relative” data and not just data that can be sold to make money.
Watch this video from Paul Wilmott and think “population health” and relate it to what’s he’s saying with all this big data and you’ll see how hard it is with all the numbers to “really” find a pot of gold as how would you find a relationship with such a huge number of patients? This is where this so called “science” fails as queries with small data might do just as well. Science need to dig around in big data like this as well as the folks in genomics but it’s way over done with giving patient care and thinking there’s some big scientific breakthrough to arrive with running the business of healthcare.
Scientists do their share of cheating too and mess with risk fiddlers and P Values as well to tweak “statistical significance” and add that on to this the Democratic Dupers and the GOP perceptions and then we really have a mess:) When the models get too complex for some non linear work, Quants and Data Scientists guess, especially if their job’s on the line. With all the complexities out there today, I might think we have a bit of guessing going on out there in healthcare, science and the financial world.
I’d like to see the day return to where I didn’t have to read through and pick off the dupes out there and the spurious correlations that people confuse for “real news” on some little number crunch that people mistake for science, that’s not science, it’s number crunch. So can these two parties get their heads together and start looking at the “real” world here so both parties can create laws that are not based on flawed and fake numbers?
Can the GOP quit saying “No” to everything and being a skeptic about anything? We do need good numbers and we are not getting that now as the sides are so far apart and it does nothing for the country. There’s sites besides mine that just rip on folks and their virtual world perceptions and yet they still keep doing it as again they have been confusing virtual values with the real world when they don’t belong and can’t tell the difference anymore.. You have to also remember the business world likes that confusion as it means profits as they will work both sides as needed.
We don’t need any more Bloomberg Big Gulp failed models and see how he was duped in and all the money and power couldn’t shove a broken model down the throats, literally of consumers. BD
If you think Epic Systems, which doesn’t issue press releases and infrequently shares much with the press, is tough for the media, you should try Meditech. I’ve never gotten a response from anyone there and never written any actual news about the company. Until now.
Today, this tweet appeared:
— Christina Noel (@Christina_Noel) November 19, 2014
So there you have it: Meditech is at a conference in Ireland today. That’s the most news I’ve ever had on that EHR vendor.
Trends and fads come and go. When they stick, it’s clear they address a consumer need, whether it’s a service, promise, or hope. Here at The Breakaway Group, A Xerox Company (TBG), we operate within a proven methodology that includes metrics, and it’s exciting to those of us who can’t get enough of good data. Most people find metrics interesting, especially when they understand how it relates to them, and the results are something they can control. Metrics are powerful.
To understand the power of data in shaping behaviors, consider the popularity of the self-monitoring fitness tracker or wearable technology. Even as their accuracy is scrutinized, sales in 2014 are predicted to land somewhere in the $14 billion range.1 Do mobile fitness trackers actually help people change their activity habits? Could doctors actually use the data to help their patients? Can companies be built on the concept of improving health with a wearable device? Not conclusively.2 Does a dedicated athlete need this kind of information? Some think not.3
So what is driving the growth of the fitness tracker market and what are these devices offering that creates millions of dedicated users? The answer is real-time data, personalized goals and feedback, and a sense of control; in other words, empowerment.
In the 70s and 80s, my grandparents spoke about their doctor as though he were infallible. They didn’t doubt, question, or even note what he prescribed, but took his advice and dealt with the outcomes. If healing didn’t progress as planned, my grandmother blamed herself, as though she’d failed him.
Jump ahead a few decades when more emphasis is being placed on collaboration. We expect our physicians to work with us, rather than dictate our treatment decisions.4 Section 3506 of the Affordable Care Act, the Program to Facilitate Shared Decision Making, states that the U.S. Department of Health and Human Services is “required to establish a program that develops, tests and disseminates certificated patient decision aids.”5 The intent is to provide patients and caregivers educational materials that will help improve communication about treatment options and decisions.6
Patient portals are important tools in helping to build this foundation of shared information. The portals house and track patient health data on web-based platforms, enabling patients and physicians to easily collaborate on the patient’s health management.7 Use of patient portals is a Meaningful Use Stage 2 objective.
The first measure of meeting this objective states that more than half the patients seen during a specified Electronic Health Record reporting period must have online access to their records. The second measure puts the spotlight on the patient and their use of that web-based information. MU Stage 2 requires that more than 5% of a provider’s patients must have viewed, downloaded, or transmitted their information to another provider in order for the provider to qualify for financial incentives from the Federal government.8
Empowered consumers want information immediately, whether it’s a restaurant review, number of steps taken in the last hour, how many calories they’ve burned, or their most recent checkup results. We like to weigh the input, make a decision, and then take action. Learning and information intake, no matter the topic, is expected to happen fast.
Metrics show us where we stand and how far we’ve come, which empowers us to keep going or make a change, and then measure again. We’re in an age of wanting to know but also wanting to know what to do next. The wearable device market has met a very real need of consumers. Whether or not fitness trackers make us healthier, whether or not our doctors know what to do with the information, or if this is information an athlete would really use, these devices can serve the purpose of putting many people in control of their own health, one measurable step at a time.
1 Harrop, D., Das, R., & Chansin G. (2014) . Wearable technology 2014-2024: Technologies, markets, forecasts. Retrieved from http://www.idtechex.com/research/reports/wearable-technology-2014-2024-technologies-markets-forecasts-000379.asp
2 Hixon, T. (2014) . Are health and fitness wearables running out of gas? Retrieved from http://www.forbes.com/sites/toddhixon/2014/04/24/are-health-and-fitness-wearables-running-out-of-gas/
3 Real athletes don’t need wearable tech. (2014) . Retrieved from http://www.outsideonline.com/outdoor-gear/gear-shed/tech-talk/Real-Athletes-Dont-Need-Wearable-Tech.html
4 Chen, P. (2012) . Afraid to speak up at the doctor’s office. Retrieved from http://well.blogs.nytimes.com/2012/05/31/afraid-to-speak-up-at-the-doctors-office/?_r=0
5 Informed Medical Decisions Foundation. (2011-2014) . Affordable care act. Retrieved from http://www.informedmedicaldecisions.org/shared-decision-making-policy/federal-legislation/affordable-care-act/
6 HealthcareITNews. (2014) . Patient pjortals. Retrieved from http://www.healthcareitnews.com/directory/patient-portals
7 Bajarin, T. (2014) . Where wearable health gadgets are headed. Retrieved from http://time.com/2938202/health-fitness-gadgets/
8 HealthIT.gov. (2014) . Patient ability to electronically view, download & transmit (VDT) health information. Retrieved from http://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures-2/patient-ability-electronically-view-download-transmit-vdt-health-information
Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.
I few days ago I posted with information from the insurer themselves that doctors will be compensated at a rate slightly above what Medicaid pays, so I’m sure that’s what’s going on here as it’s all contracts and price. Other United Healthcare polices via employers and I’m guessing Medicare Advantage plans are still ok and accepted. Insurance carriers have had a busy year with hiring armies of quants and have zeroed in on the restrictive parameters of policies they will offer and making more of them carry a very high deductible which is basically coverage for a major event for most.
We did get away from pre-existing conditions with the ACA law but now the insurer modelers have just moved that segmentation over to narrow networks to model with.
“Also there’s another reason for all of this and that has to do with the “Secret Scoring of America’s Doctors” to where the armies of Quants that have been hired by insurers use pure analytics of some type to determine risk, costs, etc. and knock them off the network. The link below has more on the number of quants that have been hired by insurers. They want us as doctors and patients to move like algos and the result is flawed data. “
As a matter of fact the data at times with insurers due to frequent model changes that are also hard on us, we have cases like this in Maryland, where United bid and won a contract but then the left quant didn’t know what the right quant was doing and the doctors in the area had already been fired so they lost the contract as they nobody to see patients. This is how the constant shuffling of insurance data, they do on purpose for profits is shuffling out to consumers.
So again, those buying a United Healthcare policy via an insurance exchange in Maryland, looks like you are out of luck for Hopkins and their doctors. BD
Hopkins, one of the biggest systems in the state, is not excluded from all of the insurer's plans or by the other carriers on the exchange, created under the Affordable Care Act for people who don't get their insurance through their employers.
"We believe patients have the right to make informed decisions regarding their health care," said Patricia M.C. Brown, senior vice president of managed care and population health for Johns Hopkins Medicine. "Unless this limitation is clearly communicated, consumers who consider plans based on price alone may not realize they are restricting their access to the quality care and expertise that Johns Hopkins provides."
UnitedHealthcare is also still negotiating with the University of Maryland Medical System.
Other carriers may yet exclude some other health systems, though officials from CareFirst BlueCross BlueShield, the state's dominant carrier, said its networks were not narrowed for exchange policies and include about 45,000 providers.
What’s the matter with people anymore with being stuck in stat rat world? Do they think an obese person is going to look at this as something positive? With as bad as companies have been today with little concern for the people they employ at times (and this is not all employers) do they think this is a positive to motivate people to lose weight? The key to losing weight is not the expense of an obese person, it’s hitting the right key note to get the person motivated to lose weight for themselves and then everyone wins and you don’t need stupid websites like this. When a person loses weight for their own self esteem, that’s the best by all means. I wrote a while back too about another sick bunch that likes to sit around and map the obese in the US. Well it’s not like they are hiding anywhere and it takes one glance to recognize one who is obese so why all the infographics? It’s because the people who do them are suffer from narcissism and want you to see their “beautiful” work and the obese who are mapped, well they could be mapping anything really as it doesn’t matter.
Actually the head of CDC was the same one who dreamed up the Bloomberg Big Gulp failed model too so again people do things by example and if you remember, look at all we went through over that failed proof of concept. Bloomberg and Frieden didn’t know when to stop. I put this Obesity site right in there with being another failed Bloomberg failed proof of concept.
Attraction is the means to motivate someone to lose weight and there are much better ways to accomplish that versus segmentation like this. The obesity calculator is gone and from what I am reading it’s a standard BMI that you can find by the groves anywhere. That’s ok but when you start directing this type of segmentation to employers, it becomes a different story. As a matter of fact, I absolutely hate the term “human capital” and wish folks would just reduce it to one word “human” as that’s what we are talking about here.
It’s to the point to where people who are not obese look at those who are with minus dollar signs in their eyes and that’s not right as the obese need a little compassion and a reason to care, not this. We have way many lost today in virtual world values this is the prime example right here. Heck look at the example the White House produces and this one got my attention as again folks confusing virtual values with real world values. Now go take a look at the fatties in Congress and nobody’s on their case are they?
The CDC already has their Work Place Health Promotion page and that’s enough and they go over board too with a “work place scorecard” and more over there too. Heck if I were an employer, the reading is fine but I wouldn’t want to put any more information about my company on the CDC site. They claim their data is “science based” but I didn’t have time to read it all but doubt all of it is, more or less some of it is just number crunching and stats. There’s more stuff and resources over there to read and again how many employers will use and read it? I’m talking beyond healthcare information to be specific to the Healthy Worksite.
Again the information is ok but it will be misleading for some as well as again they want you to share and share and share more data, and I’m out of that ball game and again I don’t any employers are going to dig into that either and we have folks that just went over the edge a bit here. I can barely stand to be in a CVS or Walgreens store anymore as all of this is just in my face constantly and I can’t browse and shop like I used too and those may be just the stores near me but I started going to Rite Aid for that reason as I get tackled over and over for flu shots and I even get that a bit in the grocery store where I go which has a pharmacy in it. When things are slow they have the pharmacist handing out coupons…yuk.
So again we had some folks living just a bit too virtual and didn’t even think how this site would be accepted in “the real world”. You have give people some space and get out of their faces and quit selling our data right and left as well. BD
Called Lean Works!, the federal program drew recent criticism from some nutritionists and advocates for overweight Americans who claimed the site and its obesity calculator fueled workplace discrimination and perhaps even led some companies to fire fat people. NBC News first reported those concerns Nov. 2.
Brittany Behm, a spokesperson for the U.S. Centers for Disease Control and Prevention, said via email that content once posted at Lean Works! “is under review,” adding: “The calculator is also under review and will be potentially updated with new information, technology.”