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Health in 2 Point 00, Episode 76 | Facebook releasing an EMR? Jim Cramer Going to Epic? #AprilFools

Facebook is releasing an EMR? Jim Cramer is going to work at Epic? April Fools! On today’s actual Health in 2 Point 00 Episode 76, Jess asks me about the follow up from Health Datapalooza, which ended with the government saying they will be changing the world and that everyone should join them in their initiative to innovate digital health. AHRQ & CMMI ran digital health challenges, and CMMI will be doing an AI challenge for $1 million for startups in the space. Speaking of the government, Seema Verma was in the news for her PR spending and as I said “Evil Twin Seema” and “Good Seema” are joined at the hip and they should “not screw around on the PR front”. In other news, MountSinai launched a digital health institute to develop advances in artificial intelligence and other emerging health care technologies spaces. Clover Health laid off a ton of people, and according to me, they are starting to get serious because running a Medicare Advantage plan is hard work — Matthew Holt

SCOOP: Facebook enters EMR business

by MATTHEW HOLT

Big news out of Mountain View, California today as Facebook COO Sheryl Sandberg announced that the social networking giant was going to formally enter the EMR business. Sandberg explained that Facebook already has all Americans and most of the world’s population on its system and that adding a little bit of information about their health would be trivial given that it’s easy with AR to abstract that information from their profiles, not to mention that everyone’s phone is already sending data back to Facebook.

In particular, Sandberg highlighted the fact that Facebook has already captured almost all the personal health information of many people with cancer and plenty of other rare diseases in the thousands of health communities that it has been pushing hard over the past few years. Not only have those individuals not known what Facebook is allowing third parties to do with that data, or which hackers have already stolen it in a SICGRL hack, but they have also found it impossible to extract themselves or their data from those groups. As Sandberg says “We already have the EMR business model down, now we just have to provide the products”

When it was pointed out to Sandberg that Facebook didn’t actually have any professional EMR tools that could be used by clinicians or doctors, a scruffily dressed guy hiding his bad haircut under a hoodie grabbed the mike and shouted “We’ve seen the schlock that Epic, Cerner and the rest put out–my wife has to use it and she spends every evening catching up on her data entry. Shouldn’t be too hard for our engineers to knock that off–just ask those guys at Snapchat.” Sandberg commented that while EMR vendors move slowly and break things, Facebook has shown over the years that it can do that much faster. “Have you seen what we did to American democracy or the EU?”

Later today Cerner stock was trading off 25%. When asked, an Epic spokesperson commented that even if you added their ages together, Sandberg and Zuckerberg were far too young to run a proper EMR company.

Matthew Holt is the Publisher of THCB

Health in 2 Point 00, Episode 75 | Rounds & IPOs, Health Datapalooza, & the Facebook Controversy

Today on Health in 2 Point 00, Jess and I are at 10th annual Health Datapalooza in Washington D.C.! Jess talks to me about Xealth’s $11 million round to develop out its company, and Change Healthcare is applying for a $100 million IPO. The big takeaways from Health Datapalooza are that many people and companies have integrated data into their systems, but they haven’t been able to gain many actionable insights from it. Also, if you haven’t heard of the complaint Andrea Downing, Fred Trotter, and David Harlow wrote to the FTC concerning the privacy and data that can be downloaded from Facebook’s groups, you better check it out. It details out the concern that Facebook is not protecting the data of patients as anyone can download sensitive data from the groups and use it — Matthew Holt

For Your Radar — Huge Implications for Healthcare in Pending Privacy Legislation

By VINCE KURAITIS and DEVEN McGRAW

Two years ago we wouldn’t have believed it — the U.S. Congress is considering broad privacy and data protection legislation in 2019. There is some bipartisan support and a strong possibility that legislation will be passed. Two recent articles in The Washington Post and AP News will help you get up to speed.

Federal privacy legislation would have a huge impact on all healthcare stakeholders, including patients.  Here’s an overview of the ground we’ll cover in this post:

  • Why Now?
  • Six Key Issues for Healthcare
  • What’s Next?

We are aware of at least 5 proposed Congressional bills and 16 Privacy Frameworks/Principles. These are listed in the Appendix below; please feel free to update these lists in your comments.  In this post we’ll focus on providing background and describing issues. In a future post we will compare and contrast specific legislative proposals.

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Health in 2 point 00, Episode 15

Jessica DaMassa asks me every question about health & technology she can fit into 2 minutes. Topics include Facebook looking for hospital data, the EU starting a VC fund, JP Morgan CEO Jamie Dimon blowing up the hype about ABC & the ACA under more assault. Jessica called this a “painful episode” but I thought it was rather good! BTW THCB will be featuring Jessica’s new video series WTF Health very soon so get prepped!–Matthew Holt

The Best Positioned Tech Giant in Healthcare Today? The Answer May Surprise You.

When you think about tech giants playing in healthcare, you think of Google and the work Verily is doing; you think of Apple and their HealthKit and ResearchKit applications, as well as their rumored plans to organize all your medical data on your iPhone; you may even think of Amazon and their potential entry into the pharmacy market.

But the name you may hear about least–Facebook–may actually be the company influencing healthcare the most, and may also be the best positioned to support the patient-centered future that so many imagine and that Eric Topol described in The Patient Will See You Now (my Wall Street Journal review here).

At first blush, Facebook seems to be doing remarkably little in health; their most notable effort has arguably been providing the opportunity to list your organ donor status, an initiative which produced an immediate lift in organ donor registrations.

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The Facebook Model for Socialized Health Care

Screen Shot 2015-02-26 at 5.06.17 PMAs government involvement in U.S. health care deepens—through the Affordable Care Act, Meaningful Use, and the continued revisions and expansions of Medicaid and Medicare—the politically electric watchword is “socialism.”

Online, of course, social media is not a latent communist threat, but rather the most popular destination for internet users around the world.

People, whether out of fear for being left behind, or simply tickled by the ease with which they can publicize their lives, have been sharing every element of their public (and very often, their private) lives with ever-increasing zeal. Pictures, videos, by-the-minute commentary and updates, idle musings, blogs—the means by which people broadcast themselves are as numerous and diverse as sites on the web itself.

Even as the public decries government spying programs and panics at the news of the latest massive data-breach, the daily traffic to sites like Facebook and Twitter—especially through mobile devices—not only stays high, but continues to grow. These sites are designed around users volunteering personal information, from work and education information, to preferences in music, movies, politics, and even romantic partners.

So why not health data?

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#Whitecoats4Blacklives

Screen Shot 2014-12-11 at 1.27.35 PMAt 3PM EST on December 10, 2014, medical and dental students at over 70 schools participated in the “National White Coat Die-In.” The event was organized on Facebook and spearheaded by students at University of California, San Francisco (UCSF) School of Medicine who described the event as “a demonstration in response to the events in Ferguson and New York because #BlackLivesMatter.”

Across the country, there have been numerous protests against the grand jury’s decision in Fergurson, Mo. not to indict officer Darren Wilson who shot and killed Michael Brown, an unarmed teenage boy. Similarly, in Staten island, NY, the grand jury decided not to indict officer Daniel Pantaleo who killed Eric Garner, an unarmed black man, using a banned chokehold.

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Facebook Is Bad For You. And Giving Up Using It Will Make You Happier

Giant Zuckerbergs
In the past few years, the fortunate among us have recognised the hazards of living with an overabundance of food (obesity, diabetes) and have started to change our diets. But most of us do not yet understand that Facebook is to the mind what sugar is to the body. Facebook feed is easy to digest. It has made it easy to consume small bites of trivial matter, tidbits that don’t really concern our lives and don’t require thinking. That’s why we experience almost no saturation. Unlike reading books and long magazine articles (which require thinking), we can swallow limitless quantities of photos and status updates, which are bright-coloured candies for the mind. Sadly, we are still far away from beginning to recognise how toxic Facebook can be.

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Actually, We’d Probably All Be Better Off With Our Health Records on Facebook

A Facebook user’s timeline provides both a snapshot of who that user is and a historical record of the user’s activity on Facebook. My Facebook timeline is about me, and fittingly, I control it. It’s also one, single profile. Anyone I allow to view my timeline views my timeline—they don’t each create their own copies of it.

Intuitive, right? So why don’t medical records work that way? There is no unified, single patient record—every doctor I’ve ever visited has his or her own separate copy of my records. And in an age where we can conduct banking transactions on my smartphone, many patients still can’t access or contribute to the medical records their doctors keep for them.

My proposal? Medical records should follow Facebook’s lead.

Cross-industry innovation isn’t new. BMW borrowed from the tech world to create its iDrive; Fischer Sports reduced the oscillation of its skis by using a technologycreated for stringed instruments. So I asked myself: Who has mastered the user-centric storing and sharing platform? The more I thought about it, the more I decided a Facebook timeline approach could be just what medical records need.
To see what I mean, let’s explore some of Facebook timeline’s key features to see how each could map to features of the ideal medical record.

“About” for Complete, Patient-Informed Medical History

On Facebook: The “about” section is the one that most closely resembles the concept of a user profile. It includes a picture selected by the user and lists information such as gender; relationship status; age, political and religious views; interests and hobbies; favorite quotes, books and movies; and free-form biographical information added by the user.

In medical records: The “about” section would be a snapshot of the patient’s health and background. It should include the patient’s age, gender, smoking status, height, weight, address, phone number, and emergency contact information; the patient’s primary care provider; and insurance information. This section would include a summary list of the patient’s current diagnoses and medications, as well as family history. And importantly, both the doctor and the patient would be able to add details.

FACEBK about-patient

“Privacy Settings” and “Permissions” for Controlled Sharing

On Facebook: Privacy settings allow users to control who can see the information they post or that is posted about them. For example, in my general privacy settings I can choose to make my photos visible only to the people I’ve accepted as “friends.” However, if I post a photo I want the entire world to see, I can change the default setting for that photo to be visible publicly instead.

Facebook also allows users to grant “permissions” for outside applications to access their profiles. For example, let’s say I use TripAdvisor to read travel reviews. TripAdvisor lets me sign in to its site using my Facebook account, rather than creating a separate TripAdvisor account. But, to do this I must grant TripAdvisor “permission” to access my Facebook account.

In medical records: Patients could use “privacy settings” to control whether all or part of their information can be seen by a family member or caregiver. For
example, if my aging mother wanted to give me access to her “events” (upcoming doctor’s appointments), she could do so. If my college-aged son who is still on my health plan wanted to give me access to his knee X-rays, he could.

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