Here are a couple of sites worth a look. First, brand new EMR player Extormity. Second, the new standards accreditation body Seedie. Don’t forget to read the fine print.
A Google Health Clinical Exam
By
Not
one more pixel need be spilt about the issues of privacy, security,
HIPAA, metastatic data, third-party crashers, or corporate imperial
overreach raised by the debut of Google Health. Let’s just snap on the
latex gloves and do a quick exam. This won’t hurt a bit.
Three brief clinical observations follow:
Your conditions, your choice
You can enter your “conditions” either by entering text or choosing
from a disheartening alphabetic menu of bodily afflictions, from
Aarskog Syndrome to Zollinger-Ellison Syndrome. The list is 20 screens
by 3 columns deep when spread out on one endless page.
Immediately preceding the last entry is
“Zits”–a nice bit of diction that helps reach users where they live, so
to speak, to humanize the Google Machine. As with many conditions that
populate the picklist (no pun), there’s a pre-loaded search for zits.
But only certain conditions are pre-loaded with searches. Although
“whiteheads” was on the list, when I typed it in there was no stored
search. When I did the search myself up popped the zits search results.
To give the product a test run as you can see below I chose a number
of conditions from the list — WHICH, IF YOU ARE AN INSURER, EMPLOYER OR
ACQUAINTANCE, I ASSURE YOU ARE ENTIRELY MADE UP AND DON’T APPLY TO ME
AT ALL, IN FACT I AM PERFECTLY HEALTHY. I also tried to throw Brother
Google a curve ball by describing the same conditions using several
different terms, i.e., arthritis, osteoarthritis and bad knees. I was
permitted to add these as I wished.
Google Health beta — What’s really new and different?
From his role as Director of Health IT for the AAFP, co-creation of the CCR and with his involvement behind the "NDA firewall" with the Google Health team, David Kibbe probably has a better vision than most about what’s new and different with Google Health. And he is indeed optimistic.
Much of the discussion about Google Health beta’s recent launch as an online PHR or healthURL seems to me to miss the point about what is really new and different.
Here’s how I see it:
1) Computability. What Google Health does that no other platform is yet capable of doing is to make personal health data both transportable AND computable. Right now, this is the news. By supporting a subset of the Continuity of Care Record (CCR) standard for both inbound and outbound clinical messages, Google Health beta makes it possible for machines to accept, read, and interpret one’s health data. It is one thing to store health data on the Web as a pdf or Word text file, for example one’s immunizations or lab results, where they can be viewed. It is a giant leap forward to make the data both human and machine readable, so that they can be acted upon in some intelligent way by a remote server, kept up-to-date, and improved upon in terms of accuracy and relevance. That is what the CCR xml subset supported within Google Health beta achieves for the consumer that is really new and different; this is what HealthVault and Dossia are to date missing.
Why no e-Prescribing in the ED?
By PAUL LEVY
As previously reported,
we have a wonderful system that permits doctors to order prescriptions
online, allowing patients to pick them up directly from their preferred
pharmacy. Recently a friend of mine went to our BID~Needham Emergency
Department, and came home with a script to get her prescription from
our pharmacy. So I inquired. Our ever helpful CIO, John Halamka,
explained:At present, e-Prescribing in the US is generally
limited to primary care practices and specialists who act as primary
care givers, i.e. cardiologists, ob/gyns, pulmonary docs, etc.
Massachusetts is the number one e-Prescriber in the country, yet only
13% of the routable prescriptions in the state go electronically. BIDMC
ambulatory clinics use it, and they are routing 35% electronically,
increasing every month.At BIDMC and BID~Needham Emergency
Departments, prescriptions are written electronically and printed to
tamperproof paper on laser printers in the department. To my knowledge,
there are no Emergency Departments in the state using e-Prescribing.
Here’s the challenge1. It is currently illegal to e-Prescribe
any controlled substance — pain killer, sedative, anti-anxiety drug
etc. Approximately 1/3 of all Emergency Department prescriptions are of
this type. Recently, the Massachusetts Department of Public Health was
able to get a DEA exemption to test one site (Berkshire Medical Center
using Meditech software) to e-prescribe controlled substances. The DEA
wants this to be a three year pilot , which illustrates how resistant
to change the DEA can be. I’ve just signed a letter along with many
health care standards and pharmacy leaders urging Congress to get
involved and accelerate the ability to e-Prescribe controlled
substances as a modification to Medicare Part D standards.
Google Health finally up and open for business
After a long time in discussion, Google publicly launched Monday its free online personal health records. The operation first made headlines a couple of months ago when Google announced it at the Healthcare Information and Management Systems Society (HIMSS). I was invited to the Googleplex, but due to a prior engagement, had to miss the chance to get it from the horses mouth.
Much like the "non-PHR" HealthVault, Google now allows consumers to download records from its eight initial partners and store them for free.
As the WSJ Health Blog points out, only a minority of medical practices keep records electronically. But the good news is that Google has been thinking not just about EMRs, but also about the rest of data that’s most useful (Rx and lab results) and has some big players, such as Medco, Walgreens and Quest on its list of initial partners.
Google will also have to spend more time now dealing with the privacy zealots and not just leaving it all to, well, me!
Although I wasn’t there, a much more famous health IT person was. John Halamka is the Chief Information Officer at one of Google’s initial partners, Boston’s Beth Israel Deaconess Medical Center (and of course colleague of THCB regular Paul Levy, and more recently himself a blogger). BIDMC has offered its patients a PHR for more than 7 years, and now that data can be brought into Google Health (and I assume vice versa). John’s post about the launch is below — Matthew Holt
By
Beth Israel Deaconess Medical Center is now live with Google Health. In the interest of full disclosure, I am a member of the Google Health Advisory Council and have not accepted any payments from Google for my advisory role. BIDMC is also working with Microsoft Health Vault and Dossia.
I’m now at Google Headquarters in Mountain View with the Google Health team – Roni, Missy, Maneesh, Jerry etc. and several dozen reporters.
Here’s the functionality we’ve launched.
When a user logs into Google Health and clicks on Import Health Records – the following choices appear:
- BIDMC
- Cleveland Clinic
- Longs
- MEDCO
- Minute Clinic/CVS
- Quest Laboratories
- RxAmerica
- Walgreens
They are all early integrators with Google Health.
At BIDMC, we have enhanced our hospital and ambulatory systems such that a patient, with their consent and control, can upload their BIDMC records to Google Health in a few keystrokes. There is no need to manually enter this health data into Google’s personal health record, unlike earlier PHRs from Dr. Koop, HealthCentral and Revolution Health. Once these records are uploaded, patients receive drug/drug interaction advice, drug monographs, and disease reference materials. They can subscribe to additional third party applications, share their records if desired, and receive additional health knowledge services.
The Technology Hype Cycle: Why bad things happen to good technologies
Fresh on the heels of my recent bar coding epiphany comes another “unintended consequences” article. It turns out that the whipsawing that accompanies the adoption of new technologies is completely foreseeable, the “Why doesn’t this thing work right?” phase is as predictable as the seasons.
Thanks to Dr. Mark Wheeler, Director of Clinical Informatics of PeaceHealth, for introducing me last week to the “Technology Hype Cycle” concept. The Cycle, originally described by the IT consulting firm Gartner, is comprised of an all-but-inevitable series of phases that technologies tend to traverse after they are introduced. The five phases are:
Wishing for a smart health search
By 
Health care consumers today want to use the Web to find information online about doctors, specialists and care in general. And they want it to be useful.
Unfortunately, in the vast health search space based mostly on ad revenue and keyword densities, consumers often spend hours clicking links into dead ends and wind up with no more knowledge for their trouble.
A semantic Web promises more accurate and meaningful results, yet this technology is in its infancy. And most “trusted” health sites do not yet support semantic searches. Moreover, semantic search requires some knowledge of how to construct a search query as opposed to a simple Google-style search.
Jay Parkinson readying for re-launch
In an interview in MDNG, Bill Schu wonders whether Jay Parkinson has sold out.
Not really, but we love him because he’s got that confidence thing down:
On the June 1 launch of Hello Health“ It’s going to kick ass. We found a space that’s a perfect location and a perfect node. [We] think the real issue is going to be managing demand.”
Whatever you think of his style, (and I’m a fan) the interface that Jay showed at Health 2.0 in March was very ,very innovative. And I for one am looking forward to the next iteration which starts June 1.
Read more about Parkinson here on THCB. The uncoventional doctor gained celebrity status last year when the media learned of his entirely virtual medical practice. Visit Parkinson’s Web site full of Health 2.0.
More opportunity for online health management
Consumers, at least Californians, do a lot of looking for health
information on the Internet — but very little health management.
California HealthCare Foundation (CHCF) has taken a snapshot of
Californians’ use of the Internet in health care. The profile is
presented in CHCF’s report, Just Looking: Consumer Use of the Internet
to Manage Care.
Topline: insured, more affluent, and younger people use the Internet in health searching.
As the chart at right details, the most popular care-related uses on the
Internet include searching for information about conditions and drugs,
finding a physician, checking ratings, and looking for claims and
benefit information online.
Some 13 percent of Californians are lucky enough to be making appointments online, and 12 percent are filling Rx’s online.
New demands of ‘Millennial patients’
"Millennial patients are the first generation of Americans to grow up with the Internet as a pervasive part of their lives. … They are amazed, bewildered, and ultimately angry with the inability to access their health care services in this way. They cannot understand, and they will not tolerate, this disparity in the ability to manage health care transactions as simply as they manage their financial transactions."
Those are the words of regular THCB contributor Scott Shreeve in an article he wrote for the April issue of MDNG magazine. Shreeve adeptly describes the next generation of patients, whom he calls millennial patients. All at once, he says, they are consumers, providers and partners in managing their health.
Then, he talks about what it means to be a millennial provider in a new technology-dependent world. Shreeve says the health care industry’s initial lag in adopting health IT can play out to its advantage — so long as it hurries up.
"By observing the wider technology adoption patterns in fast-adopting industries like financial services, we can reliably predict what trends will soon be impacting health care. We can also get a sense of how consumers, traditionally called patients within health care, will respond as they adopt—and push their providers to adopt — the technologies that will simplify their health care interactions."
