Tech

I’ve been toiling in the field of connected health for 20 years now, watching for signs of adoption that will move us into the steep part of the curve.  I have to wonder, with announcements from several huge consumer companies recently, if that time is coming.

By now you’ve heard about Apple’s HealthKit announcement , which involved not only Apple, but Mayo Clinic and Epic.

HealthKit

Continue reading “Will 2015 be mHealth’s Coming Out Party?”

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As reported last year at HIMSS and by many online news and opinion sources since, physician dissatisfaction with EHRs is growing. Indeed, while this blog post doesn’t focus on the broader picture, general physician career dissatisfaction is disconcertingly high.

The breakneck push for more and better EHR use as a component of regular medical care is a significant part of that malaise, but it is insufficient as an explanation. For the most part, doctors really don’t like what the health IT industry is giving them to work with. The HIMSS survey proves it, showing that around 40 percent of physicians would not recommend their EHR to a colleague.

One would expect an industry to develop better products and improve usability, acceptance and satisfaction over time. In health IT, the opposite has occurred, with most pointing fingers at Meaningful Use as the culprit for awkward workflows and Rube Goldberg solutions cobbled together so everyone can get paid in a timely manner.

It seems EHRs are taking more time to use rather than less, which was the original goal.

Continue reading “EHR Design: It’s a Matter of Time”

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Robert W WahIf I had to capture the main shortcoming of electronic health record (EHR) technology in one word, this would be it: Usability.

As we’re observing National Health IT Week through Friday, I can’t think of a better time to call for EHR systems that better serve physicians and our patients. That’s why the AMA just released a new framework for improving EHR usability.

As a chief medical officer for a health IT company and a former deputy national coordinator in the Office of the National Coordinator for Health Information Technology, I understand the complexities of what’s required to make EHRs first and foremost usable systems for the medical practice. When I say “all” I want for Health IT Week is an EHR overhaul, I realize that’s no simple request.

But it is a basic request. Usability should be the driving quality of all health IT. Unless health IT functions in a way that makes our practices more efficient and facilitates improvements in our patient care, it isn’t doing what it was intended to do.

Continue reading “All I Want For Health IT Week Is An EHR Overhaul”

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Daniel GarrettLook at who is entering the New Health Economy: Amazon, with digital health applications; Intel, with a home health gateway; Google, with a fit platform, not to mention the news out of Cupertino last week.

Why? According to the 2013 PwC Global Innovation Survey, nearly half of drug and device companies are focusing on traditional product innovation rather than on breaking their efficacy and safety mold. And the stakes are high: As patients become value-seeking consumers, they want quick and easy technology connections to their health source.

It appears that the biggest barrier to transforming traditional healthcare business is culture. Most (89%) of the drug and device CEOs surveyed by PwC view technological advances as the global trend to follow. Yet three-quarters of these executives cite an inability to grasp new information technologies.

Many of these firms invested heavily in social media in 2012 and 2013, but then retreated, possibly awaiting further guidance from the FDA on what is acceptable conduct for “socializing” with consumers.

In fact, the FDA released draft guidance this spring outlining rules for interactive promotional media, including blogs, social networking sites, online patient forums, and podcasts. Some companies, such as Qu Biologics, already use social media to enhance trial recruitment. Companies can scan social media for information about adverse events related to their products. A recent study showed that social media had three times more adverse-event reports for 23 commonly used prescription medications than the FDA did during the same time period.

Any cultural transformation should begin at home. Although drug and device companies say they value social media as an important accelerator of innovation, the evidence is scant on how these firms use technology to promote internal communications that can better connect employees across traditional silos—from R&D to commercial business units.

Continue reading “Those New Neighbors”

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By NIRAV DESAI

Screen Shot 2014-09-16 at 8.54.48 AM“There’s an app for that” popularizes the fact that over 1 million apps for smartphones and tablets have been developed to address anything, from small to complex, that people may want to do. In the world of mobile health, or mHealth, we’re prone to agree.

According to IMS Health, there are over 23,000 healthcare-related apps covering numerous clinical areas (from primary care to surgery), care sites (from home to acute care), users (from patients, to caregivers, to clinicians) and parts of the patient journey (from wellness to complex chronic disease). And, a recent study we conducted found that 70 percent of people use mobile apps on a daily basis to track calorie intake and monitor physical activities.

But the view of the mHealth world as just a proliferation of apps, while exciting and important, is flawed in several ways:

  1. It ignores the fact that while apps may be primary user touch points in a mobile-connected world, they are not the only ones.
  2. It leaves people with the idea that all you have to do to solve a problem is build an app.  Often, the solution is much broader.

Healthcare is evolving beyond “there’s an app for that.” Here’s what’s happening…

Continue reading “mHealth – Beyond “There’s an app for that””

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Screen Shot 2014-09-14 at 1.49.42 PMWith the fast adoption of smart phones, tablets and wearable devices, the way people communicate, travel, eat and entertain have all been simplified. Why not streamline the way we experience healthcare as well? A study released in May 2014 from MDLive discovered that 82% of young adults 18-34 would prefer consulting with their doctor via a mobile device than show up for an appointment. Twenty seven percent of patients confirmed they’d be willing to give up shopping for a month, skip their next vacation, even refrain from showers for a week—if it meant they would be able to access their doctor via a smart phone! These results, along with the multiple surveys and studies conducted in the past year, confirm that a new way to conduct healthcare services is in high demand.

The solution to changing up the healthcare system sits at the center of three key advancements: patient engagement, population health and electronic health records (EHRs). At eClinicalWorks, we consider these components of healthcare to be like a three-legged stool where two cannot stand without the other. We recognized this need as an opportunity within the healthcare IT space and created healow in order to provide our customers and their patients with a platform to schedule doctors’ appointments and get immediate access to medical records via an online interface or mobile app. healow empowers doctors and patients by packaging personal health records (PHRs), healthcare tools and appointment scheduling together, making the data readily accessible to patients and their doctors from the palm of their hand.

Continue reading “What Would You Give Up For a Virtual Doctor Visit?”

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Apple Watch Med

Surprise #1. It’s not called the iWatch, as many observers had predicted.  Meet the Apple Watch.

Surprise #2. No camera.

Not really-a-surprise: The $350 price tag is now trending on Twitter.

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Shaywitz of EldredThe great promise of wearables for medicine includes the opportunity for health measurement to participate more naturally in the flow of our lives, and provide a richer and more nuanced assessment of phenotype than that offered by the traditional labs and blood pressure assessments now found in our medical record.  Health, as we appreciate, exists outside the four walls of a clinical or hospital, and wearables (as now championed by AppleGoogle, and others) would seem to offer an obvious vehicle to mediate our increasingly expansive perspective.

The big data vision here, of course, would be to develop an integrated database that includes genomic data, traditional EMR/clinical data, and wearable data, with the idea that these should provide the basis for more precise understanding of patients and disease, and provide more granular insight into effective interventions.  This has been one of the ambitions of the MIT/MGH CATCH program, among others (disclosure: I’m a co-founder).

One of the challenges, however, is trying to understand the quality and value of the wearable data now captured.  To this end, it might be useful to consider a evaluation framework that’s been developed for thinking about genomic testing, and which I’ve become increasingly familiar with through my new role at a genetic data management company.  (As I’ve previously written, there are many parallels between our efforts to understand the value of genomic data and our efforts to understand the value of digital health data.)

The evaluation framework, called ACCE, seems to have been first published by Brown University researchers James Haddow and Glenn Palomaki in 2004, and focuses on four key components: Analytic validity, Clinical validity, Clinical utility, and Ethical, Legal, and Social Implications (ELSI).   The framework continues to inform the way many geneticists think about testing today – for instance, it’s highlighted on the Center for Disease Control’s website (and CDC geneticist Muin Khoury was one of the editors of the book in which the ACCE was first published).

Continue reading “Should Wearables Data Live In Your Electronic Medical Record?”

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People are becoming more conscious about their health. It’s why fitness apps are booming and both Apple and Google are looking to get into the health game. But apps that try to go beyond simple calorie counting and movement tracking often struggle to gain traction with users.

Although people are open to sharing how many steps they’ve taken or how much they weigh, they’re more hesitant to share their personal medical details.

Here are some data-related fears consumers often have with healthcare apps:

  • Personal medical information could get leaked. Revealing users’ medical information could be embarrassing and life shattering.
  • Companies could use the data for marketing purposes. Imagine your spam getting smarter about your personal health details. Companies are already pinpointing viewers’ interests, and revealing this information could expose you to targeted email spam and calls tailored to your health issues. Members of Congress have already discussed legislation that would forbid medical apps from selling personal data without the user’s consent.
  • Unqualified employees could access their information. Patients feel comfortable divulging medical information to a doctor, but they probably wouldn’t want the IT guy who supports the app to see and read their information.

There are many reasons people might hesitate to use your app. But by identifying potential concerns and considering them as you develop and market your app, you can quell their fears and ensure the long-term success of your medical app. Continue reading “Why Nobody Is Using Your Health App (And How to Fix It)”

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John Haughom MD whiteWhen I write or speak about healthcare transformation, I am often asked why I do not criticize more. Criticize health system leadership. Criticize governmental policies. Criticize burdensome regulations. It’s a long list. Why avoid criticism? The answer is simple. Discerning emerging solutions is much more productive and fun.

We are living during a very interesting period in the history of health care. No doubt, it is a time of great transition. We are passing from one time to another. Transition periods are important, yet they are hard to define because it’s difficult to determine exactly when they start and when they end. To understand the transition healthcare is now experiencing, we must do our best to understand what is on either side of it.

The traditional approach to delivering care has served us well and accomplished great things over the past century. Yet, it is also being overwhelmed by complexity and producing inconsistent quality, unacceptable levels of harm, too much waste and spiraling costs.

The traditional method of delivering care is struggling and another is emerging to take its place. Because the traditional approach has served us well and accomplished great things, we want to believe that the present state will continue forever. Because conditions have changed, this will not happen. We are in need of a new approach. An approach that carries the best of the past forward, yet also addresses present day challenges. It just might be that on the other side of this current transition is potentially a time unmatched by any other in the history of healthcare. Thanks to visionary clinical leaders at institutions across the country, there is growing evidence this is not only possible; it is likely.

Who does the future belong to? If we look closely at other transition periods in history, two groups of people are apparent. The first are what we recognize as critics. They are people whose response to the need for change is criticism. Critics always exist, but in a time of transition they tend to multiply. What do they criticize? They criticize the new, they criticize the change, they criticize the change for being unnecessary or too fast, or they criticize the change for being too slow. They criticize anything and everything. Critics are abundant. The question we should consider is, “Will criticism solve problems?” Typically, it does not.  While constructive criticism has its place, it alone is not likely to accomplish much especially when the world is yearning for innovative solutions.

Continue reading “It is Time for Clinicians to Engage: Let’s Criticize Less and Dare Greatly More”

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