The Ebola crisis in Texas has tested our nation’s health care system in many ways, exposing weaknesses and potential breakdowns. In particular, the incident with the first diagnosed Ebola patient at Texas Health Presbyterian underscores a fundamental issue with information liquidity between providers, their care teams, and across the continuum of care. The ability to share information effectively is critical not just in responding to health care crises like Ebola — but also in delivering great, cost-effective care.
As athenahealth CEO Jonathan Bush said in an interview with CNBC earlier this month:
“The worst supply chain in our society is the health information supply chain. It’s just a wonderfully poignant example, [a] reminder of how disconnected our health care system is. … The hyperbole should not be directed at Epic or those guys at Health Texas. The hyperbole has to be directed at the fact that health care is islands of information trying to separately manage a massively complex network.”
Continue reading “Ebola and the Information Flow Challenge”
Filed Under: Tech, THCB
Tagged: athenahealth, Design, Ebola, EMR, Epocrates
Oct 28, 2014
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)”
Filed Under: Tech, THCB
Tagged: Apps, Data, Design, Reputation
Sep 8, 2014
I’ve been thinking about EMRs, electronic medical records, lately. It’s a subject, despite some professional experience, I don’t feel particularly close to. In fact, if anything, they are a source of consternation.
As an industry insider, I see them as an expensive albatross around our collective neck. As a human centered design advisor, I see them as an encumbrance for both providers and patients.
And, as a patient I see them largely as an opaque blob of data about me with a placating window in the form of a portal.
Which makes me wonder, am I obsessed with EMRs lately?
One of the reasons is certainly my personal interest in technology. And, while I don’t work in health IT, it’s natural to draw some connections. For instance,Wikipedia is consistently in among the top 10 most visited internet sites ( it is currently number 6 ).
And, say what you will about citing Wikipedia, but a 2010 study found it as accurate as Britanica.
Google trusts Wikipedia enough to use it as the primary source for its knowledge graph cards; and we’ve all settled a bar bet by finding some fact where a Wikipedia article is the canonical answer.
The secret sauce for Wikipedia is in it’s roots. Literally, the root of its name, wiki, describes the underlying structure. Wikis were the internet’s a solution to knowledge bases – large repositories of information about a process or thing. Companies had been using knowledge base software for years. Traditionally, a central maintainer, often a sort of corporate librarian, curated information, such as common answers to customer questions, so customer service reps could find it quickly.
Continue reading “What If EMRs Worked Like Wikipedia?”
Filed Under: Tech
Tagged: Design, EMRs, Nick Dawson, Privacy, Wikipedia, Wisdom of the Crowds
Aug 28, 2014
Innovations Help Patients Share Their Lives with Health Care Providers
The California HealthCare Foundation (CHCF), Mad*Pow and Health 2.0 today announced the winners of the “Putting Care In Context” design challenge which sought innovative ways to help patients take an active role in sharing information about hurdles in their lives that impact health.
The three winning solutions each empower patients to share information about issues like hunger, poor housing conditions, stress, and isolation with their health care providers. The winners are:
- First place: Healthify is a web-based platform used to assess patients’ social and behavioral health needs, refer patients to appropriate resources to meet those needs, and engage patients around their social determinants via interactive texting. The platform also provides dashboards for managed care plans and case managers to use, allowing them to better manage the social needs in their population and to efficiently search for social services.
- Second place: Share4Care is a design prototype of an iPad app that would allow patients to document stress levels and issues in their life while in a clinical waiting room. The Share4Care app would then calculate a “Life Change Score” and assign a color (green, yellow, or red) that would be immediately available to the patient’s physician, prompting them to ask about factors that could impact the patient’s health.
- Third place: MyDay Media Messaging Journal is a web-based platform that patients use to document their barriers to health through photos and text messages. The MyDay website and mobile app allow providers to view patients’ journal entries and follow-up to build patient-provider rapport, clarify journal entry content, and connect patients with resources.
The creators of these ideas will share $10,000 in prize money for their thoughtful, original work.
“We believe that healthcare providers must understand the hurdles in a patient’s life that can be a barrier to good health,” says Amy Cueva, Founder and Chief Experience Officer at Mad*Pow. “These winning concepts can help engage patients to share this important personal information, leading to more effective care.”
The challenge was first announced at the HxRefactored conference on May 14, 2014 in Brooklyn, NY. A healthcare experience, design and technology conference, HxRefactored fused the technical and creative elements of Mad*Pow’s Healthcare Experience Design Conference and Health 2.0’s Health: Refactored.
“The winning solutions – all at varying stages of development – demonstrate different ways that patients can be engaged to share information about their lives outside the clinic walls” said Giovanna Giuliani, senior program officer with the California HealthCare Foundation. “From a one-time assessment in the waiting room, to a daily social media-inspired approach, to a more developed web-based screening tool, these solutions will spark new ways to think about promoting conversations and care that addresses the whole person.”
For more information on the design challenge and the winning entries, visit http://bit.ly/CareInContext.
About the California HealthCare Foundation
The California HealthCare Foundation works as a catalyst to fulfill the promise of better health care for all Californians, supporting ideas and innovations that improve quality, increase efficiency, and lower the costs of care. For more information, visit www.chcf.org.
Mad*Pow is a design agency that improves the experiences people have with technology, organizations and each other. Using human-centered design, Mad*Pow creates strong multi-channel experience strategies, intuitive digital experiences and streamlined processes for its clients. The company has offices in Boston, Portsmouth, NH and Louisville. For more information, visit www.madpow.com.
About Health 2.0
Health 2.0 promotes, showcases, and catalyzes new technologies in health care through a worldwide series of conferences, code-a-thons, prize challenges, and leading market intelligence. Visit www.health2con.com for more info.
Filed Under: Health 2.0
Tagged: #challenge, #socialdeterminants, #underserved, #UX, Design
Aug 14, 2014
In an era of sophisticated information technology and rapid communication, the medical device community lags far behind other fields in its ability to alert patients about safety concerns.
For example, auto manufacturers and government regulators are able to quickly identify potential safety concerns by linking reports of crashes, malfunctions and defects with individual vehicle identification numbers (VINs).
They can then communicate recalls to affected customers by using their VIN. Manufacturers will issue notifications via mail or e-mail, or offer customers the ability to search the manufacturer’s website using their VIN.
In health care, drugs are tracked using a system established in the 1970s called National Drug Codes (NDCs). The 10-digit NDCs are assigned to all manufactured medications. The code tracks the vendor, product, and package code, which can then be captured in electronic health records and the FDA’s national database.
Unfortunately, we do not yet have a similar national system that can identify and communicate potential concerns for the tens of millions of patients with implantable devices such as pacemakers, glucose meters, artificial joints, and defibrillators.
Patients are bombarded by news stories about device recalls, but unless they have access to information about the exact make and model of their device, they have no way of knowing if they should be concerned. Since most medical device procedures take place in a hospital, a patient’s health care providers may also lack this critical, sometimes life-saving information.
The patient is then burdened with the task of tracking down their specialist or surgeon, in hopes that they documented the specific device information.
Clearly, the current health care information infrastructure does not yet support a robust surveillance system.
Continue reading “Medical Devices and Patient Safety: A Promising Path Forward”
Filed Under: Uncategorized
Tagged: Craig Daniel, Craig Streit, Design, Medical Devices, national drug code (NDC), Patient Safety, Siromi Gardina, unique device identifiers (UDIs)
May 4, 2014
At the first White House public workshop on Big Data, Latanya Sweeney, a leading privacy researcher at Carnegie Mellon and Harvard who is now the chief technologist for the Federal Trade Commission, was quoted as asking about privacy and big data, “computer science got us into this mess; can computer science get us out of it?”
There is a lot computer science and other technology can do to help consumers in this area. Some examples:
• The same predictive analytics and machine learning used to understand and manage preferences for products or content and improve user experience can be applied to privacy preferences. This would take some of the burden off individuals to manage their privacy preferences actively and enable providers to adjust disclosures and consent for differing contexts that raise different privacy sensitivities.
Computer science has done a lot to improve user interfaces and user experience by making them context-sensitive, and the same can be done to improve users’ privacy experience.
• Tagging and tracking privacy metadata would strengthen accountability by making it easier to ensure that use, retention, and sharing of data is consistent with expectations when the data was first provided.
• Developing features and platforms that enable consumers to see what data is collected about them, employ visualizations to increase interpretability of data, and make data about consumers more available to them in ways that will allow consumers to get more of the benefit of data that they themselves generate would provide much more dynamic and meaningful transparency than static privacy policies that few consumers read and only experts can interpret usefully.
In a recent speech to MIT’s industrial partners, I presented examples of research on privacy-protecting technologies.
Continue reading “Using Technology to Better Inform Consumers about Privacy Decisions”
Filed Under: Uncategorized
Tagged: Apps, Big Data, Brookings Institution, Cameron Kerry, Consumer Protection, Design, Privacy
Apr 30, 2014
By DAVID DO, MD
WILD PREDICTION: It won’t be long before every patient has a Twitter feed, and doctors subscribe to them for real-time updates.
This is a time when the demands of being a physician are changing, and we need to leverage technology to maintain awareness of a huge number of patients. There is also increasing need for handoffs and communication between providers.
Here’s the bottom line: how can we improve technology when doctors seem so resistant? They are not happy with their EMRs, and rightly so, because they were built to do too much for too many.
Current system is inefficient
The EMR has become essential for documentation, billing, medical reasoning, and communication, among other things. Currently, documentation is built on a system of daily progress notes. If I consult a cardiologist about a case, he needs to go through each note, containing narratives, laboratory values, vital signs, and physical exams.
A patient with a seven-day hospital stay may have twenty notes that need synthesis to put together the story–this can take hours per patient!
In an age where more providers are involved in a patient’s care (whether due to duty hour restrictions, or the increasing presence of specialists for every problem), this inefficiency is not acceptable.
Continue reading “What an EMR Built on Twitter Would Look Like”
Filed Under: Tech, THCB
Tagged: David Do, Design, EHR, FutureMed, Social Media, Twitter
Apr 27, 2014
Je n’ai fait celle-ci plus longue que parce que je n’ai pas eu le loisir de la faire plus courte. —Blaise Pascal
Translation: I have made this longer than usual because I have not had time to make it shorter.
As Appley as it gets.
A while ago I was challenged to write about what an Apple-like approach to healthcare might look like.
That challenge has been weighing on me.
For starters, we’re all over Appled aren’t we? Maligned anecdotes about Steve Jobs and the iPhone make their way into almost every presentation remotely related to innovation or technology. Triteness aside, I’ve been stalled because Apple is really a philosophy, not a series of steps or lessons learned. (Although, they are nonetheless methodical.)
Instead, what I’ve been kicking around in the ole noggin are three notional predictions, which I’ll assert are inevitabilities which will fundamentally disrupt healthcare delivery as we know it today.
What follows is about as Appley as I’m likely to get. Despite big-bang product launches, Apple actually plays the long game. They introduce small features into products to affect user behavior years before a flagship product takes advantage of those reprogramed behaviors.
That’s how they disrupt.
I believe there are three meaningful, unstoppable trends, in our current world which will significantly alter healthcare. The steps taken towards these inevitabilities, along the way, are what will define the innovators and leaders. They are the ones who see this future and know how to drive towards it.
The three trends are:
- Tools and culture which favor individual empowerment
- The commoditization and automation of diagnosis
- Accelerated globalization of treatment options
But wait, there’s Moore.
Don’t worry, I’m not going to leave you hanging. I’ll attempt to rationalize each of these points and explain why, particularly when considered as a bundle, they are a powerful force for disruption. And to prime that pump, we have to talk about Gordon Moore.
Continue reading “Moore’s Law in Healthcare – Three Predictions”
Filed Under: Tech, THCB
Tagged: Apple, consumer driven health, Design, diagnosis automation, digital health, DIY medicine, FutureMed, Gordon Moore, health care delivery, Innovation, Intel, Moore's Law, Nick Dawson, Patient Portals, specialized treatment options
Apr 23, 2014
Our friends at Kaiser Permanente asked us reach out THCB readers for help with a cool crowdsourcing project. The Kaiser innovation team is working on developing new content for The Kaiser Permanente Center For Total Health , KP’s shiny new 16,000 square foot exhibition and meeting space in downtown Washington D.C.
If you’re close enough to make the trip, we highly recommend that you stop by and take an hour or so to poke around a bit before submitting your suggestions. Failing that, you can take the online interactive tour here.
If you’re a doctor, a med student, a designer, an entrepreneur, a patient – or if you just have a good idea – we’d like to hear from you. KP’s innovation team asked us to ask you four questions. You can answer one or you can answer them all.
1. What is Total Health? In other words, what is health? What’s important to you?
2. What should total health look like when implemented? What innovations can be used to drive change in the healthcare system? What will healthcare look like in the future?
3.How should total health be supported? What can be done to make healthcare better? Smarter? Both within the healthcare system? And in our own lives?
4. If you were designing an interactive wall to demonstrate total health to visitors what would you focus on. In other words, if you were designing an exhibition what would it look like? What would your message be? What would help educate the public? How would you get that message across? Yes, you can send us an picture.
Answers can be left in the comment thread below. If you prefer to submit a video response via YouTube send the link to email@example.com. or paste in the comments below. Blog posts should be submitted to THCB editors at firstname.lastname@example.org
For the interactive design question, we asked THCB’s editors what they’d like to see. Here’s what we came up with on the back of our paper napkin:
Continue reading “Crowdsourcing the Kaiser Permanente Center For Total Health”
Filed Under: THCB
Tagged: Center For Total Health, Crowdsourcing, Design, Education, Kaiser Permanente
Mar 14, 2014
I’ve recently returned from the 7th ID Ecosystem Steering Group Plenary in Atlanta. This is an international public-private project focused on the anything-but-trivial issue of issuing people authoritative cyber-credentials: digital passports you can use to access government services, healthcare, banks and everything else online.
Cyber ID is more than a single-sign-on convenience, or a money-saver when businesses can stop asking you for the names of your pets, it’s rapidly becoming a critical foundation for cyber-security because it impacts the resiliency of our critical infrastructure.
Healthcare, it turns out, is becoming a design center for IDESG because healthcare represents the most diverse collection of human interactions of any large market sector. If we can solve cyber-identity for healthcare, we will have solved most of the other application domains.
The cyber-identity landscape includes:
proving who you are without showing a physical driver’s license
opening a new account without having to release private information
eliminating the risk of identity theft
civil or criminal accountability for your actions based on a digital ID
reducing your privacy risks through anonymous or pseudonymous ID
enabling delegation to family members or professional colleagues without impersonation
reducing hidden surveillance by state or private institutions
when appropriate, shifting control of our digital tools to us and away from corporations
The IDESG process is deliberate and comprehensive. It impacts many hot issues in health care including patient matching, information sharing for accountable care and population health, health information exchanges, prescription drug monitoring programs, accounting for disclosures, patient engagement and meaningful use, the physician’s ability to communicate and refer without institutional censorship, the patient’s ability to control information from our increasingly connected devices and implants, and more.
Hospitals and health industry incumbents that seek to solve the hot issues raised by health reform are not eager to wait for a deliberate and comprehensive process. For them, privacy and cyber-security is a nice-to-have. Who will pay for this digital enlightenment?
Continue reading “IDESG Is a Glimpse of Our Digital Future”
Filed Under: Uncategorized
Tagged: Adrian Gropper, Cyber ID, Design, FutureMed, IDESG, Privacy
Jan 26, 2014