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Health and safety

by System Administrator - Wednesday, 1 April 2015, 4:21 PM

Health and safety


The nature of our work and the environments in which we operate expose some of our employees to a high risk of harm.

Mitigating and managing these risks so that our people can return home safe every day remains our paramount concern.

The group health and safety strategy sets the framework and provides a vision of how each business can progress from a level of compliance with health and safety regulation to a level of differentiation where we lead the industry in health and safety.

We recognise that attaining the differentiation level (below) across the group will only really be achieved where a culture of health and safety prevails and where thinking and acting safely is the norm for everyone.




In 2013, we focused on putting the foundations in place to support a safety culture, establishing levels of health and safety resources, gathering information on how health and safety is perceived across the group and piloting tools and training that will help us share health and safety knowledge and understanding as we seek to improve.

In 2014, we will build on these foundations and provide our senior management population with specific training to enable them to set health and safety behaviours for their businesses to follow. We are also reviewing the skills and training required by health and safety practitioners so that they can support senior managers in implementing the strategy effectively.

With a global fleet of around 35,000 vehicles, many of the health and safety campaigns and tools which were piloted in 2013 related to road safety. Incidents involving vehicles result in many of the workplace injuries and fatalities across the group and are a major risk we believe we can reduce.

Using information from past experiences, a road safety steering group developed a set of standards, rules and training materials which were piloted in seven countries. Feedback on the pilots has been very positive and the focus on road safety appears to have had an impact. There has been a reduction in road traffic-related fatalities in a number of the seven pilot countries from 17 in 2012 to five in 2013. In 2014, the materials developed for the pilot countries will be made widely available to all businesses and we will continue our focus in this area.

During 2013, 55 colleagues lost their lives in the line of duty, principally as a result of attacks by third parties and road traffic incidents. Their loss is deeply felt by their families and their colleagues and is a matter of great concern for everyone at G4S. This has caused us to redouble our efforts to mitigate the risks faced each day by many of our colleagues.

The Group Executive team is leading a programme to strengthen safety leadership and safety practices across the group. We have improved our incident investigation and reporting process to gather more detailed information on root causes and to help businesses ensure all recommendations are fully implemented.


An online health and safety community for sharing best practice was another tool developed in 2013. Making this tool available to all health and safety practitioners will facilitate more knowledge sharing about incidents and unsafe working conditions or practices so that continuous improvements can be made.

Underpinning the strategy is a set of core health and safety standards against which businesses self-assess every year. Compliance is monitored and periodically audited with reviews of performance at a regional, group and board level via the CSR Committee.

Our critical country reviews provide further insight to ensure health and safety incidents have been thoroughly investigated and the recommendations acted on. These CCRs are conducted by internal health and safety experts who travel to different countries where there have been work-related fatalities.

As well as independently assessing the health and safety processes in the countries visited, the reviews also help to raise awareness and share good practices. In 2013 CCRs were conducted in Malaysia, Iraq and the Philippines by health and safety experts from Africa and the UK and Ireland regions. The resulting action plans are monitored at a regional and group level.

Health and safety information on lost time injuries and incidents is also gathered as part of the monthly Key Performance Indicators (KPIs) and helps identify businesses where there are higher risks of harm to our employees and we can ensure appropriate health and safety resources are allocated.



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Health App to Link Patient Data with Physician EHRs

by System Administrator - Thursday, 21 August 2014, 3:56 PM

New Health App to Link Patient Data with Physician EHRs

By Beth A. Balen

There are all kinds of health apps that track blood pressure, medications, nutrition, exercise, you name it. WebMD has one. Weight Watchers, Nike, FitBit, and CVS pharmacy and Walgreens pharmacy do too. A huge new player coming to the market in the fall of 2014 is Apple's "Health" app, which will be a standard feature of the new iOS8. Health will provide users an easy-to-read dashboard that integrates all their fitness and health data into one convenient place.

The Health app will gather data from many fitness and health apps, giving easy to access information on exercise, lab results, medications, food, sleep, and vitals, such as blood pressure.

Health also includes a new tool called "HealthKit" that will allow outside developers to give their own apps access to your health data, even giving you the ability to share that data with your doctor's EHR.

The connections between EHRs and Apple's Health app don't exist yet, but they may be active as soon as this fall. I question whether doctors would be interested in such a gadget, as it could potentially provide a lot of irrelevant data. But, a feature of Health gives patients the ability to choose which data they wish to share with health providers, so perhaps the doctor would just want to receive daily blood pressure or weight measurements.

Apple worked with the Mayo Clinic for the past five years to develop HealthKit. They have also been working with UCLA and Stanford Hospitals, Cambridge University Hospitals, Nike, and Epic.

Mayo Clinic's marketing medical director, John Wald, says they want to use their own health app to communicate with the HealthKit's cloud information repository, using it to access personal health information and develop relationships with their patients, before they get sick. They are already using their app with HealthKit to monitor specific vital signs such as blood pressure, and to alert the doctor if readings are out of normal ranges.

Wald says he is convinced that physicians will use this new technology, since their lives can be made easier by keeping patients healthy. It also could help physicians earn some extra money if they are taking advantage of payer incentives that reward them for keeping their patients out of the hospital. Physicians can be slow adopters of new technology, so it remains to be seen whether this will pan out.

Here's what I see as practical user benefits and adoption tips:

• HealthKit-type programs could help with compliance. The second stage of the government's meaningful use requirements includes patient engagement through electronic tools. Most often this happens through either a secure Web portal or secure messaging between patient and physician. Since one of the requirements is that at least 10 percent of patients actually use that system, geeky people like me might gravitate toward it more, if apps are available for health interaction.

• Medical data sharing and monitoring may help physician offices get some of those insurance bonuses for keeping their patients healthy. And wearable devices that communicate the data directly will be more accurate than the patient's self-report, for instance, of how much the patient exercised this week.

• If using an EHR giant like Epic, the technology may be closer to going live than you might think. If you use Epic, start talking with your vendor now to start planning for this future functionality.

• Patients will have to be aware of the Health app. Once the new technology is available it could be communicated to patients in the same way you communicate about your patient portal. Some offices give every patient a handout on the portal and how to access it. Include the apps you communicate with, and the data you would like them to report.

• Choose specific information to have the patient share so the data is not overwhelming and potentially ignored due to sheer volume. This new digital functionality may just be the next version of disruptive technology in the healthcare world.


93% believe EHR-connected mHealth apps benefit patient care

Author Name Jennifer Bresnick

Physicians want patients to use mHealth apps as much as patients themselves do, a new survey by EHR vendor eClinicalWorks says.  From scheduling appointments and emailing nurses to receiving follow-up reminders and accessing their own EHR data, mobile smartphone apps have numerous uses before, during, and after a clinical visit, and an overwhelming majority of physicians are eager to embrace the technology.

More than ninety percent of the 650 physicians polled believe that mHealth apps have the potential to improve patient outcomes, and an equal amount would like to see apps give patients the ability to upload data into their personal EHR file. Eighty-nine percent would recommend an app to a patient in the future.

The ability to send patients reminders and alerts topped the mHealth wish list for respondents, followed by allowing patients to access their PHI from mobile devices, making it easier for patients to conduct administrative tasks like appointment scheduling, and getting more accurate self-reported data from patients on a regular basis.  Preventative care, diabetes monitoring, weight management, and medication adherence were all areas of opportunity for mHealth apps to address.


The mHealth market is expanding rapidly, and is expected to reach 1.7 billion usersworldwide by 2017, according to a recent prediction.  Patients are beginning to trustdownloadable apps as much as a live clinician even as physicians are starting to accept the idea of patient-reported data being useful for diagnosis, monitoring, and treatment.  With mHealth tools projected to save more than $500 billion in productivity, travel, and administrative costs over the next ten years, both consumers and providers are taking notice of the market’s potential.

“In order to transform healthcare, patients need to be engaged,” said Girish Kumar Navani, CEO and co-founder of eClinicalWorks. “People are invested in and want to be engaged in their health as long as they trust the source of the information.”  Apps provided by or otherwise linked to their trusted providers may help drive patient engagement ahead of Stage 2 meaningful use, which requires 5% of patients to access or download their health information online through a portal.  With more than half of the survey’s participants representing primary care, the pervasive willingness to adopt mHealth seems to bode well for the Stage 2 requirement and the future of mobile healthcare.
Related White Papers:
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Health care transformation

by System Administrator - Monday, 4 May 2015, 3:25 PM

Health care transformation: Using proven methods to accelerate change

The era of fee-for-service is far from over, and providers can still thrive while focusing on delivering a high volume of hospital and ambulatory care, rather than on eliminating unwarranted variation improving the health of a population, says Glenn Steele Jr., M.D., Ph.D., president and CEO of Danville, Pa.– based Geisinger Health System and chairman of the board of xG Health Solutions.

However, he also notes that the U.S. health care system is not as efficient as it should be, and we are all paying for it. "We pay financially, and then, God forbid, if one of our family members or one of us has to get care, we’d like to know where to go to get the best possible outcomes. And right now, that’s pretty opaque."

Public and private payers alike have recognized the need for health care transformation—changing payment models and provider and patient behavior to drive the delivery of higher-value care. In turn, providers are just beginning to recognize it is time to change their approach.

"There’s a huge amount of change that we’re going through," Steele says. "The capabilities required to take care of a population of patients, the ability to provide care for episodes of hospital-associated care at lower cost, but better outcomes, the fundamental move toward an attack on total cost of care . . . the need for that is straightforward."

What is not as straightforward is how to smoothly switch to a focus on value. Still, based on years of innovation and experimentation, Steele says, Geisinger has figured out some ways to cut costs while improving quality.

Geisinger’s guide to value reengineering

The most significant lesson other health systems can learn from Geisinger’s experience concerns the importance of provider-led value reengineering and care redesign, Steele explains. It takes much more than simply revamping the payment structure. Everyone—from physicians to nurse practitioners to pharmacists—needs to be on board.

"Unless providers really believe that, at the end of the transformation process, care for their patients will be better, it doesn’t happen," he says.

By making essential cultural changes and using a team-based care approach, Geisinger has seen success through innovations such as its ProvenCare® model of evidence-based protocols and its ProvenHealth Navigator® advanced medical home model.

How and why health systems should ‘activate’ patients

For a health system to thrive under value-based population health models, its patients must become "co-directors" of their care, Steele explains. He calls it "activating" patients.

For example, Geisinger takes part in the OpenNotes initiative, which lets patients read the notes in their electronic health record.

"If we can use a number of fairly straightforward techniques—like making our notes available to all our patients—they’ll become much more actively involved," he says.

Overall, Steele says Geisinger has the knowledge and know-how required to improve quality and cut national health care costs by 30 to 40 percent. It is simply a matter of making the transition on a large scale.

"It’s a done deal in my brain," he explains. "That’s the challenge: How do we scale this against all of the incentives that are still working very, very well for the hospital-centric organizations out there?"

Please read the attached whitepaper.

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Health Data in the Blood

by System Administrator - Wednesday, 19 November 2014, 8:27 PM

Latest XPRIZE Winner Unleashes the Health Data in Your Blood


Today the XPRIZE Foundation announced the winner of the Nokia Sensing XCHALLENGE, the global competition aimed at accelerating the availability of hardware sensors and software sensing technology as a means to smarter digital health solutions. The winning device, called the Reusable Handheld Electrolyte and Lab Technology for Humans (rHEALTH) system, can potentially run hundreds or even thousands of lab tests using a single drop of blood, and those tests, in turn, can be used to diagnose a range of diseases.


Along with a number of distinguished awards, the $525,000 grand prize was presented to Eugene Chan, founder and CEO of the device’s maker, DNA Medicine Institute (DMI), at Singularity University’s Exponential Medicine conference.

How does the device work? The rHEALTH system reacts a sample of blood–about 1,500 times less than is usually required–with a series of nanostrips. These strips are bit like pH test strips, only they’re on the scale of blood cells. The system reacts the blood sample with tens of thousands of nanostrips, each running a different test then shines a laser on them in rapid succession.

The whole process yields results in around two minutes and currently runs about 22 lab tests, ranging from vitamin D to HIV.


"Currently we are developing our rHEALTH sensor, which is designed to be a universal health sensor with capabilities to assess hundreds of different clinical lab tests in a single drop of blood or bodily fluid. It also features a detachable wireless vitals sensor module for monitoring all vital signs. We recently successfully tested the performance of our technology with NASA on a series of parabolic flights over 160 parabolas and from gravity levels from zero to 1.8 g. We are on track to developing a version of our technology for routine consumer and clinical use."

You can learn more about the device at an in-depth article over on Wired.



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by System Administrator - Thursday, 16 April 2015, 2:14 PM



"People want to be engaged in their healthcare decision-making process, and those who are engaged as decision-makers in their care tend to be healthier and have better outcomes."

Please read the attached whitepaper

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Health IT hiring remains 'consistent'

by System Administrator - Saturday, 2 August 2014, 12:20 AM


Clinical application support continues to be a major hiring need for healthcare organizations, according to the Healthcare Information and Management Systems Society's second annual workforce survey.

Sixty-four percent of provider respondents (106 individuals) identified clinical application support as their top area of IT need for 2014, up from 51 percent the previous year. What's more, 58 percent of respondents said they would be most likely to hire clinical applications support staff in the future. Comparatively, 35 percent of respondents said they would most likely hire IT security staff in the future.

Continue reading

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Health IT System Integration and Interoperability: Challenges and Solutions

by System Administrator - Tuesday, 16 September 2014, 8:23 PM


Health IT System Integration and Interoperability: Challenges and Solutions

As the healthcare industry continues to move toward value-based reimbursement models, healthcare systems and providers increasingly depend on accessing all of a patient’s data quickly, regardless of where they previously received care. The brisk rate of mergers and acquisitions and rapid growth in accountable care organizations make resolving the challenges of interoperability and system integration even more timely.

For this book, we spoke with provider executives and experts around the country to learn more about how healthcare organizations have simplified sharing and accessing data internally and with primary care physicians, specialists and imaging centers—all with the goal of improving patient care at lower cost and with greater efficiency.

Download this eBook to learn:

  • How Accountable Care Organizations use technology to coordinate care across multiple settings and disparate systems
  • How to solve the myriad of interoperability woes in the wake of a merger or acquisition
  • How to share images across settings and systems and how doing so can improve revenue, drive down expenses and increase quality care


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Health Tech Entrepreneur Hardships

by System Administrator - Friday, 12 September 2014, 1:05 AM

DoctorBase CEO Talks Health Tech Entrepreneur Hardships

Right now, innovations and the companies that create them are abounding in HIT. But that doesn’t mean that cracking the code to HIT success is all that easy. Even an experienced entrepreneur like John Kim says that healthcare is a difficult space for startups. And he should know. He started one.

In April 2010, Kim cofounded DoctorBase, a developer of a cloud-based communications platform that offers mobile engagements to patients for providers. The San Francisco, CA-based company seems to be steadily growing as its platform moves into small and mid-level health organizations. Kim said he knew that the idea for DoctorBase was a solid one, having had previous success with his startup Five9and its development of virtual call center software.

Still, it hasn’t been all smooth sailing for DoctorBase. Kim admits encountering his fair share of snags in the healthcare space, which have since humbled him. As a result, we at HIT Consultant wanted to sit down with Kim and talk about his successes and stumbles as an health tech entrepreneur, and how they are helping him shape the future of DoctorBase as its Cofounder and CEO:

Let’s start with talking about DoctorBase and how the company came to fruition: What was the inspiration and thought process behind forming the company and devising the patient-doctor communications technology?

In 2010 we saw the power of marketing automation software that was starting to become adopted by mainstream businesses, and we knew eventually, it was going to find its way into healthcare. We’re seeing that without marketing automation, patient engagement doesn’t operate efficiently at scale or get adoption from either providers or patients. 

Marketing automation is the secret sauce to effective patient engagement; so being better at healthcare marketing automation than anyone else has always been our focus.

What was it about DoctorBase that made you think it was a project worthy of pursuing? What elements stuck out to you about the technologies that were going to give you an edge on the competition?

Our first customer (the office manager for a doctor’s office named Linda) sent me a 2 word email in all caps. “LOVE IT.”

That’s when we knew we were onto something.


You have had notable success with launching multiple startups outside of the healthcare space. Tell me a briefly about what those experiences compare to DoctorBase: What’s been the greatest departure or change in approach that you had to adapt to when it comes to the HIT space?

The toughest lesson for me was also the most humbling one. Based on the moderate success of my previous SaaS company Five9, I thought that we would walk into healthcare IT and “revolutionize it.” What we found, and are still learning, is that healthcare is actually a byzantine network of different industries, and not all of them are governed by traditional business rules or economic forces.

From a technical or product perspective, we now push thousands of messages per day between providers and patients, and in healthcare you just can’t have “routine scheduled downtime maintenance” like you can with many B2B SaaS companies. The goal for the margin of allowable error is always nearing zero in healthcare.

What are/were some of the key challenges that you have encountered with launching DoctorBase? 

We face a three pronged challenge each day:

1. How do you get patients engaged with their doctor and their medical staff without over-burdening the medical providers?

2. How do we make the lives of the medical office staff easier?

3. How do we get healthcare providers to collaboratively engage in meaningful ways that go beyond simple point-to-point email?

Furthermore, how have those challenges changed your perspective on the HIT space? Were there assumptions or expectations you had that yielded different results?

Many, many experts told us that medical professionals would not build their own social network on our platform or answer patient questions for free on their downtime. With thousands of our doctors answering patient questions for free on our platform (even though this new feature is just seven weeks old), our users have proven that the critics were wrong. Ultimately, all credit goes to the doctors and mid-levels who answer consumers – the critics just underestimated their compassion. Amidst all of this reshuffling of the healthcare economic cards, healthcare providers are healers by calling – nothing is going to stop them from helping people.

Would you say that the consumer mentality is different in healthcare?  Which part is the trickier piece of the puzzle, appealing to providers or to patients? Naturally, you are selling to providers, but you have to make sure you have a product that patients will use. Has that been part of the challenge at all?

Here’s the tricky part of healthcare economics (and I’m part of this American sentiment as well so guilty as charged): When we’re healthy, we want to pay for the equivalent of cheap, federally subsidized cafeteria food. When we’re seriously ill, we want the hospital with the Louis Vuitton suite. That’s a tough challenge.

What about the fact that DoctorBase started with a strictly mobile offering? Did that create unforeseen challenges?

We started as a desktop offering that was forced to move to a dual-mode delivery platform that was heavily based on mobile experiences. If one thinks about it :

A) Office staff are on Wintel desktop computers during their work hours.

B) Doctors are on both desktop and mobile (heavily iOS) during work hours (for many doctors, all waking work hours are potential work hours). Also, throw in a high adoption rate of iPads amongst doctors.

C) Patients can be heavily Android depending on the geographic area. We’ve seen in some of our neighborhoods that Android devices can be over 70% of the patient population on our platform.

Building a seamless user experience with singularity of purpose-as-per-role is a constant puzzle, challenge and joy to work on with a three user interface – patient, provider and staff.

We are starting to get marketing agencies and practice management consultants using our platform on behalf of their clients, so that may be another user base we need to learn from and address. However, this was totally unexpected as a user base even as of last year and we’re still learning about their needs as more healthcare organizations employ the professional services of agencies and consultants. 

How has tackling these challenges changed the way you view the company and product offerings? What about the consumers?

DoctorBase has nearly doubled each year over the lifespan of our last four years, and we did it without VC funding. Healthcare has both humbled me and taught me to have more of a long term view on both the company and how our product innovations spread their influence over time.

Now having experienced some of these challenges firsthand, why do you think it’s so difficult to build a successful health-tech startup as an entrepreneur?

There are so many reasons why health-tech is so difficult for entrepreneurs, but I’ll list the top three in descending order of importance:

1. The biggest challenge is what Jason Lemkin of Saastr refers to as “VC Overhang.” In healthcare this is especially true, where you have companies that after raising several million dollars need a sizable exit in an industry where the potential M&A companies have more conservative valuations than VCs.

2. Lack of integrations kill nearly any good health IT ideas. Integration into existing EHR, billing, and PMS systems are a must if one’s idea is going to actually scale. We know this is especially difficult for a young startup, so our CTO has been documenting our APIs in the hopes that one day the increasing amount of Y Combinator, TechStars and Rock Health companies asking DoctorBase to license our integration libraries (we integrate to over 27 different EHR and PMS systems) can do it in a safe, affordable manner.

3. The patient owns the data. The doctor owns the patient (relationship). The office manager owns the office. 

Building an organizational culture that respects these fundamental truths was a lot harder than one might think.

Are there unique challenges to consider when garnering funding, or creating an appropriate yet scalable business model in the HIT space?  If so, what are they? Additionally, How do you ensure that you are growing your business at the right pace and what risk do your run when it comes to premature scaling?

Most of the money in healthcare is in the services of delivering care -not technology. It’s a wonderful time to be raising money for your health-tech venture because there is an ocean of money out there right now, but both investors and developers have to be aware that there are very few potential bIllion dollar ARR companies in digital health currently. It’s important for entrepreneurs not to over-promise their investors, prepare their team for the long journey across the desert, and drink lots of fluids along the way. 

If you build your culture right, it will be an amazing road trip and the scale issues will resolve themselves simply because your team will help you pilot and adjust along your maze-like journey.

As a result of all you have learned, where is DoctorBase today? What important changes have you made and what direction is the company headed in as a result?

Deloitte released a study showing that 2014 was the breakout year for secure messages between providers and patients, and there’s potential legislation next year with bi-partisan support that would allow doctors to be reimbursed by Medicare for accepting patient messages. By being amongst the first platforms to gain traction in engaging providers, admins and patients in meaningful, collaborative and time-efficient ways, DoctorBase will be at the forefront of how healthcare access will be defined – and paid for.

What is the critical lesson here for ambitious health-tech entrepreneurs?

Walt Disney once said, “My best product goes home each night.” 

Similarly, in health-technology it’s all about the team. We just hired Joshua Angeles from ZocDoc to be our first VP of Sales – the energy his team brings to the office is infectious, both to our engineers and support team. 

From a product perspective my focus is on the next version of our platform, called PANDA Black – a culmination of 4 years of learning, mistakes and discoveries. I will wake up in the middle of the night and start working on it again because I can’t sleep, and often notice half of my engineering team is still on Slack (our group messaging application). We’re just loving it. 

The team is everything.

Is there any one thing you wish you had done differently from the beginning? More importantly, is there anything that you definitely being doing differently as DoctorBase moves forward?

I wish that we had found a co-founder from day one with a deep background in building great customer service teams. We had to find one later, and it cost us big time.

Are the elements that made this project worth pursuing, have they changed at all, or have they still held true?

It’s wise to follow Steve Job’s adage to “build useful things,” but in health-technology, those useful things better be monetizable relatively quickly and with a sizeable total addressable market to boot.

DoctorBase CEO Talks Health Tech Entrepreneur Hardships by Erica Garvin


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Health Wearables

by System Administrator - Thursday, 23 October 2014, 7:57 PM

Health Wearables Still In Its Early Days, PwC Reports Reveals

Health wearables are still in the early stages of technology and product adoption cycles, according to PwC’s Consumer Intelligence Series – The Wearable Future report – an extensive U.S. research project that surveyed 1,000 consumers, wearable technology influencers and business executives, as well as monitored social media chatter, to explore the technology’s impact on society and business. In conjunction with The Wearable Future report, PwC’s Health Research Institute (HRI) also launched a separate report, Health wearables: Early days, further examining consumers’ attitudes and behaviors toward health wearable technology.

According to Greentech CEO Ian Clark, health wearables are “a bit trivial right now.” “I don’t doubt that the wearable piece is going to be a productive business model for people. I just don’t know whether it’s going to bend the curve in terms of health outcomes,” Clark said at the recent Rock Health Innovation Summit.

While fitness bands, smart watches and other wearables are already established in the market, many of them have under-delivered on expectations. Consider that 33 percent of surveyed consumers who purchased a health wearable technology device more than a year ago now say they no longer use the device at all or use it infrequently. Currently, only 1 in 5 American adults owns a wearable device with only 1 in 10 using it on a daily basis.

Key drivers of the low adoption rate include:

- Price

- privacy

- security

- lack of “actionable” and inconsistent information from such devices

In fact, 82 percent of respondents were worried that wearable technology would invade their privacy and 86 percent expressed concern that wearables would make them more vulnerable to security breaches.

In order for health wearables to take advantage of the $2.8 trillion healthcare opportunity, companies must better engage the consumer, turn data into insights and create a simplified user experience to improve consumer health.  Additional key findings and recommendations from HRI’s Health wearables: Early days report include:

- Consumers have not yet embraced wearable health technology in large numbers, but they’re interested. More than 80 percent of consumers said an important benefit of wearable technology is its potential to make health care more convenient. Companies hoping to exploit this nascent interest will have to create affordable products offering greater value for both users and their healthcare partners.

- Consumers do not want to pay much for their wearable devices; they would rather be paid to use them. Companies – especially insurers and healthcare providers – offering incentives for use may gain traction. HRI’s report found that 68 percent of consumers would wear employer-provided wearables streaming anonymous data to an information pool in exchange for break on their insurance premiums. Moreover, consumers are more willing to try wearable technology provided by their primary care doctor’s office than they are from any other brand or category.

- While employers and health company executives expect wearables to provide valuable insights, few consumers are interested in using wearables to share health data with friends and family, and, citing concerns about privacy, consumers trust their personal physicians most with their health data. Therefore, companies should ensure privacy policies are crystal clear. Physicians already have the trust of consumers, and healthcare organizations have expertise in protecting personal health information. Consumers will want to see those high standards applied to health wearables data, especially as they become integrated into electronic medical records.

- Consumers may need a human touch to help them choose a device and its associated apps. An “apps formulary” of apps vetted by medical teams (and available in a virtual apps pharmacy) could help consumers wade through the thousands of health apps and devices.

“For wearables to help shape the New Health Economy, next generation devices will need to be interoperable, integrated, engaging, social and outcomes-driven,” said Vaughn Kauffman, principal, PwC Health Industries. “Wearable data can be used by insurers and employers to better manage health, wellness and healthcare costs, by pharmaceutical and life sciences companies to run more robust clinical trials, and by healthcare providers to capture data to support outcomes-based reimbursement. But it will be critical to address the consumer concerns that we’ve identified, such as cost, privacy, and ease of use.” For more information,

Both reports are available for download at:  

The Wearable Future

Health wearables: Early days


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Healthcare 3.0: Get Ready for the Patient Empowerment Revolution

by System Administrator - Wednesday, 14 October 2015, 2:15 PM

eBook | Healthcare 3.0: Get Ready for the Patient Empowerment Revolution


Welcome to the Patient Empowerment Revolution, a tsunami-like trend toward patients as equal partners in all aspects of their care. Where once patients mostly followed doctor's orders, now they're questioning almost everything. Where they used to enter exam rooms as passive specimens, they now arm themselves with megabytes of data that previously could only be accessed by medical school graduates. Educated "consumer patients" are forcing titanic shifts in the way healthcare is delivered to and experienced by the masses.

Spurred by consumers seeking the best quality of care for the lowest cost, and brought to you by advances in technology, an army of more informed patients is about to dramatically change how providers deliver care and how payers insure them.

But how did we get here?

Please read the attached whitepaper.


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Healthcare Applies Innovation from Other Industries for Big Impact – Breakaway Thinking

by System Administrator - Wednesday, 8 July 2015, 10:13 PM

Healthcare Applies Innovation from Other Industries for Big Impact – Breakaway Thinking

by Jennifer Bergeron

The following is a guest blog post by Jennifer Bergeron, Learning and Development Manager at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.

Healthcare is applying innovations from other industries to make advancements in the study of disease, surgery, and research. If you’re fascinated by new ways to use everyday tools and at the same time make life easier, also known as lifehacks, you can appreciate the same concept in healthcare.

3D imaging, cellphone camera technology, and sonograms like those used in underwater navigation are all being used in healthcare. Let’s begin with a look at cellphone technology and one way it is being applied to healthcare.


UCLA researchers developed a lens-free microscope that, through a series of steps, allows tissue samples to be formed into a 3D image using a microchip that is the same type found in your cellphone camera. The image shows contrast so the researcher can see tissue depth. This lens-free microscope also offers a broader, clearer view than conventional microscopes. The result is that “the pathologist’s diagnosis using the lens-free microscopic images proved accurate 99% of the time”, according to a recent study.   In order to apply this same concept to disease, imagine that a researcher could isolate a section of diseased tissue, remove it from its environment, color code the tissue to easily spot abnormalities, and have the ability to study it from all angles. reminds us that lasers, used in missile defense, in the world’s fastest camera (which takes 6.1 million pictures per second), in entertainment devices such as Blu-ray players, and in grocery check-out lines, are also used in surgery and diagnoses. Lasers can decrease the diagnosis time and cause less disruption to a patient’s comfort. Zero-dilation Scanning Laser Opthmalogy (cSLO), a new imaging technique, can diagnose a patient with diabetic retinopathy, which causes progressive damage to the retina, in as little as 3 minutes.

Technology is not only impacting the patient experience, but how caregivers are brought up to speed on new technologies. In fact, the founder of The Breakaway Group based the company’s electronic health record (EHR) learning concept on flight simulation. Flight simulators train pilots how to maneuver in extreme circumstances, situations that would be difficult to create in real life. At The Breakaway Group, we use simulation technology to increase adoption of EHRs by training providers, nurses, and healthcare professionals.

Speed to proficiency, one of four key adoption elements of The Breakaway Method, provides learners with real-life situations in a safe environment.  Learners can quickly experience many different circumstances, fail, and learn to complete tasks correctly, all without affecting patient outcomes. In addition, The Breakaway Group can cut classroom time in half on average by using simulations.

Healthcare is reaching into other industries to become more efficient and effective. Whenever information is shared and innovations are repurposed to make a process better, we all benefit.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.

Related Posts:

  1. Healthcare Innovation in a Brave New World – Breakaway Thinking
  2. Engaging Clinician Leadership to Adopt Healthcare Technology – Breakaway Thinking
  3. Healthcare Super Bowl – Winning with EHR Adoption – Breakaway Thinking
  4. Top 4 HIT Challenges and Opportunities for Healthcare Organizations in 2015 – Breakaway Thinking
  5. Factors that Influence Healthcare Information Technology Adoption – Breakaway Thinking


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Healthcare Content Management

by System Administrator - Thursday, 7 May 2015, 4:16 PM

Healthcare Content Management

Lexmark's healthcare content management (HCM) is a comprehensive approach that combines industry-leading technology to solve the information challenge across your enterprise.  HCM includes solutions in document management, enterprise medical imaging and output management, providing you with all the tools you need to connect, manage, view and share a complete patient record from within the core applications you use everyday. That means precise information for more informed decisions and enhanced patient care.

Enterprise content management and clinical imaging are coming together and healthcare systems are benefiting from two useful sets of technology.

Perceptive Intelligent Capture accurately extracts the right information from paper and electronic documents based on their type and content–all in context. Unlocking this valuable insight in documents speeds processes from days to minutes, while also helping organizations realize efficiencies that result in greater customer and staff satisfaction.

Have you tried to incorporate intelligent character recognition (ICR) into your forms processing solution only to be disappointed? Are you considering it, but have concerns? A well-configured ICR solution can achieve over 95% recognition success with low error rates. In this webinar, Parascript experts shed light on how to get the best performance from an ICR solution, and share some of the most recent advancements in ICR technology:

  • learn the latest in ICR technology; including noise removal, contextual analysis and orthogonal analysis
  • understand considerations for business rules that drive when manual keying will be used, and how to optimize the manual keying process
  • view a live demo of Parascript's FormXtra forms processing software


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Healthcare Costs a Different Look

by System Administrator - Saturday, 20 December 2014, 10:55 PM

Healthcare Costs a Different Look

by Anthony Wunsh

President/CEO Medical Pay Solutions, Consultant, Author, Speaker

It seems that once someone grabs onto an idea with political or ideological traits to it, they defend it till the end, in spite of new information, factual evidence contrary to that agenda or history to support a different result or outcome.

I must admit I have probably been guilty of it from time to time as well.

But nowhere does this play out more than within the Halls the Healthcare Kingdom, and I am often puzzled by this because we have so much history, it is a vertical driven by gathering facts, (you can't be wrong or often people die), on accessing circumstance, analyzing symptoms and then creating a treatment regiment to combat the illness or injury presented by the patient. And this puzzles me as we don't attack the challenges of reducing costs, or increasing access with the same diagnose and treat mentality within the vertical itself. We ignore empirical data, we ignore past treatments that went wrong, we involve additional decision makers and we acquiesce power to those not trained to treat the illness.

Yes I am using metaphors this morning as today my thoughts are going in an abstract manner, with the hope of maybe opening new eyes and changing old minds.

So in that abstract mindset, lets explore together some things that should not be disputed.

We have roughly 325 million people in the USA, and we billed in just the delivery of care 2.9 trillion dollars in 2013. So doing the math, the only exact science on the planet, this means per capita we spent roughly $9,000 per person (or billed this). And when you rank this to other countries we are in the top tier of how much per person we spend.

Now play along with me please, as I am trying to provide a different perspective to the madness and chaos these conversation seem to devolve into based on ideology.

Lets take ACA and deal simply with the promised cost to avoid any argument about what true costs are as they simply are disputed constantly.

So the stated goal of ACA was to provide access to care for the 42 million supposedly uninsured, the cost to do this per the promise was 900 billion over ten years. Well if you simply look at the math, these 42 million have always been counted in the per capita cost of care data, so we are adding an additional $2,300 per each of the 42 million to the cost per capita, or more simply put adding more per person for care. And if you are adding cost how can the promise of reducing cost ever have been real.

We also know that 85% of the population already had insurance. We also know that the insurance costs for those 85% went up as a result as well as the out of pocket costs for all those who were insured. Now this is not the actual cost of care, this is in addition to those numbers.

So stay with me please, if indeed you were going to commit 90 billion dollars a year to insuring that those without insurance had access to care, why disrupt the 85% who already had something they were happy with. Why not create a high risk pool and deposit the 90 billion into it and use it exclusively for those who were already identified as the ones in need. A finite cost, without changing a system that the vast majority were happy with. I suspect most would have not had a problem with this.

I do have to point out that according to the Census Bureau the uninsured were not who the powers that be wanted us to believe. These are the numbers from the same government that told you we were evil for not providing access to care for these people.

Of the 42 million, 18 million were under age 35 and CHOSE not to have insurance. A gamble indeed some would say, however the numbers are on their side, this demographic consumes less than 2% of all cost of all care in the USA. So they chose to buy homes and cars and other items rather than give money to a product they were likely not to use.

The second category were 14 million already eligible under Medicaid before expansion, which we have to assume they chose to not enroll because they had not needed the care in a recent time, if they had the provider of care would have tried to enroll them to get paid.

The last category were 11 million immigrants, either legal or not, for this example it was not stated.

So exactly who was it we had to disrupt the entire system for.

But setting aside the merit of how ACA was designed, would it not have been better to commit dollars to providing the access to care for the identified groups at risk, rather than disrupt an entire system? And would it not have been better to simply use the funds to provide the care, not insurance which will be paid for even if the care is not consumed.

Okay, I am sure I am losing your interest so just a couple of more comments, the true cost of ACA now is calculated somewhere between 200 and 300 billion a year of public money and has more than doubled the private sector costs for insurance as well as increased the per patient out of pocket costs, so in reality we have increased the actual per capita cost of getting access to care by as much as $6,000 per person, while promising to reduce costs. How does this make sense, how can math the only exact science be manipulated to say what you want it to say rather than be taken at face value and used to address the real problems of cost and access.

And then we have the history to compare past government programs in the vertical. Medicare was promised to never cost more than 5 billion dollars a year when passed, and that was projected out some 25 years when done. Last year it cost in public money more than 400 billion, a far cry from the promise.In Massachusetts the so called Romney care was promised to never cost more than 1 billion a year of public money and last year it cost the tax payers in that state almost 6 billion, 600% more than promised less than a decade ago, and this is what ACA was modeled after, so should we not expect the same cost results.

Until we attack the true cost drivers, we will never realize lower costs and more access, everything the government pushes on the vertical has unintended consequences on both cost and access to care. Much I have detailed for years.

We need to access what the third party payment system adds to the cost of care and find a better way.

We need to access the cost of restricting insurers to state lines and correct this.

We need to access the present state of malpractice laws and adjust them

And we need to access the state of regulatory costs and access if they are hindering or helping and adjust.

These fixes are in our grasp and would change the vertical in a positive manner for all consumers of care and providers of care.

There are simply too many mouths feeding off the 2.9 trillion dollar care delivery trough who bring no actual value to the delivery of care and too much money spent on the protection from needing care.

I would love to hear all perspectives and create debate that actually motivates real change to the real cost drivers, as we reduce cost, we increase access to all those supposedly identified as at risk. The higher we drive cost the further we move away from the always touted goal of providing more access to more patients. It simply is a math problem, the more expensive you make something the more you limit who can afford it, and it doesn't matter who is paying for it.

We have to remember, government does not produce one dollar by itself, every dollar it spends has to come from the effort and production of something not of government, so not only do we pay more for the products and services directly, we pay more taxes to cover the costs on that side as well, and the math does not lie.


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Healthcare Executive Insights

by System Administrator - Tuesday, 10 March 2015, 10:42 PM
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Healthcare interoperability is 'non-negotiable,' military says

by System Administrator - Sunday, 15 November 2015, 5:53 PM

Healthcare interoperability is 'non-negotiable,' military says

by Kristen Lee


Healthcare interoperability is high on many organizations' priority lists. Cerner Corporation and the Department of Defense (DoD) are not exempt.

"Interoperability, it's non-negotiable for us," Colonel Nicole Kerkenbush said. "We have to have that in order to provide the best care to our beneficiaries." Kerkenbush is military deputy program executive officer for the Defense Healthcare Management Systems within the DoD.

"We think fundamentally every person has the right to their information no matter where they are," Zane Burke, president at Cerner Corporation, said at the CHIME15 Fall CIO Forum in Orlando, Fla.

Burke detailed Cerner's efforts to make widespread healthcare interoperability a reality, including the company's involvement with CommonWell Health Alliance, a vendor-backed interoperability group.

"We now have 30-plus company corporate members that have joined CommonWell that represent over 70% of the acute EHR marketplace [that] has gotten together to create a set of standards to work together so that that information is available," Burke said. "We have about 1,200 

Cerner providers that have signed up for CommonWell today."


"We think fundamentally every person has the right to their information no matter where they are."

Zane Burkepresident, Cerner Corporation

Burke added that Cerner is also  focused on the open aspect of healthcare interoperability, citing SMART on FHIR app development platform as an example.

"Systems ought to be able to take other applications and layer them into a platform and utilize that data and that platform in a way that makes everything interoperable in an easy fashion," Burke said. "So you're not doing point-to-point interfaces; you're literally in the workflow of the clinician."

And the DoD listed interoperability as a high priority when considering bids for the agency's EHR contract, Kerkenbush said. "We have a two-fold mission in our office: one is EHR modernization, and to that end we've acquired the Cerner product … which gets us in the game a different way than we have been in the past," Kerkenbush said. "Our second mission was the interoperability piece."

She added that the DoD is very interested in joining the dialogue surrounding interoperability standards. Although both Kerkenbush and Burke agree that more standards are needed, they do not believe the lack of standards is necessarily barring interoperability in healthcare from happening.

Let us know what you think about the story and healthcare interoperability; email Kristen Lee, news writer, or find her on Twitter @Kristen_Lee_34.


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Healthcare IoT Obstacles

by System Administrator - Thursday, 20 April 2017, 6:10 PM


Overcome Healthcare IoT Obstacles

The progression of healthcare IoT, or the Internet of Medical Things, is not without its challenges. Download a PDF of this exclusive guide now and learn how to overcome the obstacles: security, data overload, regulations, and more.

Please read the attached guide

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Healthcare IT Glossary

by System Administrator - Sunday, 15 March 2015, 8:41 PM

Healthcare IT Glossary


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Healthcare IT Startups

by System Administrator - Friday, 12 September 2014, 3:27 PM

What's Hot, Not in Healthcare IT Startups

By Brian Eastwood

Healthcare attracts much interest from startups. It's not surprising, really. Most incumbent electronic health record (EHR) vendors are too busy to innovate, says Matthew Holt, co-chair of Health 2.0; they must focus on meaningful use and ICD-10 instead. Providers grapple with similar problems, plus the emerging challenges of accountable care and changing business models.

Healthcare startups, then, find themselves in a market mirroring the tech landscape of the late 1990s, when companies developed core enterprise products to fill gaps left by Microsoft. Look at America's healthcare industry today – poised to exceed $3 trillion in 2014, with much of that money spent on chronic yet preventable conditions – and it becomes clear just how many gaps there are.


Efforts to fill those gaps vary. Put another way: Some markets are hotter than others. To gain some clarity, Health 2.0, StartUp Health and Rock Health – all of which work closely with healthcare entrepreneurs – discuss where they see the most and the least action. Their assessment of startup activity in 15 key areas of healthcare follows.

(Note: We talked general trends, not hard and fast numbers. Also, the "hot," "warm" and "cold" labels were determined by and are subjective. Finally, companies and products are mentioned solely to provide examples, not to offer endorsements.)


Hot: Sensors and Connected Devices

Wearable tech gets the runway treatment and just about every major hardware maker sells a smartwatch. Healthcare's interest, though, turns to sensors and devices with more specific purposes. AdhereTech makes smart pill bottles to note the time and location pills were taken and send reminders about missed doses; this improves medication adherence. Cohero Health does something similar with inhalers. Many diagnostic devices plug into smartphones, too, increasingly making Dr. McCoy's medical tricorder less science fiction and more reality. "There are entire new businesses being formed around these sensor-enabled and connected devices," says Unity Stoakes, president and co-founder of StartUp Health.


Hot: Home Healthcare

Where would prefer to spend your golden years: At home or in an assisted living facility? That single question explains the high interest in home healthcare services, from doctors on demand (Medicast) to a caregiver marketplace (CareLink) to wearable sensors that monitor everyday behavior and send alerts is anything is amiss (CarePredict). "They're making it much more efficient and easier to stay in the home," Stoakes says, adding that interest isn't limited to Baby Boomers. Meanwhile, Holt notes that, while such devices are largely for consumers, they're increasingly becoming part of the overall health system. 


Hot: Big Data and Analytics

Connected devices create data. So, too, do electronic health record (EHR) systems, other clinical apps, billing systems, pharmacy records – the list goes on. "This market is emerging to make sense of the data and make it useful and meaningful and actionable," Stoakes says. Healthcare analytics case studies (examples here and here) target many aspects of hospital operations, from reducing readmissions to cutting costs to making sense of bundled patients (Aver Informatics) and lab data (Medivo) to quickly getting the right antibiotics to patients with bacterial infections (LuminaCare). Also of interest, thanks to healthcare reform: Price data transparency, which shows providers, payers, employers and employees what they will (or, as the case may be, will not) pay for particular procedures.


Hot: Population Health Management

Healthcare still doesn't have all the data necessary to make business decisions – but it has more than it used to, as data sets from payers and the Centers for Medicare and Medicaid Services are now more readily available. This provides an "entry point" for companies aiming to go beyond mere data aggregators to more complete solution providers, says Teresa Wang, strategy manager at Rock Health. Population health management primarily identifies and targets an institution's most at-risk patients, examining ways to offer preventive care or outreach that helps patients stay healthy and out of the emergency room. Much of this can be automated, from reporting to patient education to appointment or test reminders.


Hot: Payer Administration

With health insurance companies often seen as the Bad Guys responsible for spiraling healthcare costs, it's little surprise that there are opportunities for startups to help payers trim management and administration costs. Desired functionality includes business process automation, prescription administration, health information exchange and claim adjudication – and, of particular interest in a post-reform world, with a growing number (and complexity) of health plans for a growing number of buyers, benefit plan and member eligibility management. Oh, and don't forget analytics.


Warm: Patient-Facing Tech

Here there's some disagreement. Technology such as patient portalswearable technologyand fitness trackers "haven't seen big successes yet," StartUp Health's Stoakes says; they don't integrate with clinical workflows and struggle to save money, add revenue or save time for providers.

Rock Health, on the other hand, ranks "healthcare consumer engagement" among its emerging themes of 2014. Such technology receives funding, Wang says, because it helps address healthcare reform's stated goal of streamlining the industry. It also ties into the "evolution of the accountable care organization," Health 2.0's Holt says, as it makes patients more informed participants in a more coordinated healthcare process.


Warm: Video

Recent Deloitte research says one in six doctor visits will be virtual this year in the United States and Canada. Established vendors exist in this market – namely, WellDoc and American Well – but activity persists, with Grand Rounds and Doctors on Demand (advised by "Dr. Phil" McGraw and funded by Sir Richard Branson) among the firms (and big names) getting in on the action.

For all that's happening, though, Holt admits that a lot of the companies are doing the same thing, or at least something similar. Stoakes, for his part, says StartUp Health still expects activity around video-enabled health interactions but adds, "We thought it would have happened by now."


Warm: Digital Therapy

This broad market segments address chronic conditions, such as diabetes, hypertension or obesity, which are better treated with more continuous monitoring of a patient's condition than the status quo of infrequent in-person doctor visits. This involves sensors and apps – or, in the case of Proteus Digital Health, a small sensor in each pill a patient swallows – but also a more direct connection to a physician than a smartphone app or wristband. The idea is to use software to deliver better clinical outcomes, Wang says: "It makes healthcare much more accessible." The digital therapy market has grown 20-fold since 2011, Wang says, albeit from a small benchmark.


Warm: Physician Search

Health 2.0 Research Analyst Kim Krueger has tried a few physician search tools, with limited success. It's a novel idea, and one on which many companies hope to capitalize, but it remains "an area that's very complex [with] not a lot of abstraction at the moment," Holt says. At issue: Looking for a doctor is a "very complex algorithm," one that must incorporate a physician's diagnostic history, a patient's personal preference and a variety of other factors that, for many reasons, aren't readily available or publicly reported.


Warm: Clinical Trials

Clinical trials are expensive. Not coincidentally, they also rely on a lot of paper – for patient-reported outcomes as well as clinical outcome assessments. Seems like an easy place to get started, as Wang puts it. Digital solutions (either through smartphones or tailor-made devices) could be used in all phases of the clinical trial, from design to recruitment to monitoring to maintenance to post-trial market reporting. There's interest, Wang adds – but, as with digital therapy, this particular market segment has received less absolute funding than some of those previously discussed.


Cold: Gamification

Standalone gamification apps faded from view as the industry learned that getting healthy isn't a game. "You need something that will sustain behavior change," Wang says. That said, the concept of game mechanics, along with excitement about its potential, has found its way into tools for patient engagement and wellness, Holt says. (Think of programs that offer coupons, discounts and other rewards for participants who consistently make healthy choices.) Gamification has also emerged on the provider side as a motivator for continuing medical education, Krueger adds.


Cold: Enterprise Wellness

Employee wellness programs have had pockets of success, but many struggle, including those that offer free or discounted fitness trackers. The problems mirror those of many other types of patient engagement. Not only must the technology be right; the marketing, the motivating factors, the incentives (tangible or otherwise), the rewards and the lasting value all have to be right as well. What's more, the firms that operate in the enterprise wellness market are well-established and "relatively dominant," Wang says. Not surprisingly, this tempers startups' interest.  


Cold: Personal Genomics

The cost of mapping the human genome has dropped from $100 million in 2011 to less than $5,000 today. Inexpensive, readily available genomic research could fundamentally change diagnostics, predictive analytics and drug development. However, aside from 23andMe and despite an influx of venture capital, there's a "So what?" factor attached to personal genomics, Holt says. (It doesn't help that 23andMe drew the ire of the FDA, which says it provided results that weren't "analytically or clinically validated.") Patients' persistent struggle to share information with providers, physicians' reluctance to trust third-party data and cash-strapped providers' unwillingness to pass up revenue from pricey tests may all play a part here.  


Cold: Personal Health Records

Google Health rests in peace, Microsoft HealthVault languishes and patient portals stillhaven't caught on. Blame poor design, Holt says, as well as the inability to connect to enterprise systems. (Such negligence is understandable; after all, patients use portals or PHRs much less frequently than, say, social media sites.) Consumer health data platforms could be the answer, he adds, as could data utility layers from fitness device makers, who have plenty of personal health data on hand.

Holt spoke to before Aetna scrapped CarePass and Apple told developers not to store health data in iCloud. Neither development bodes well for any startup aiming to help patients take control of their personal health information.


Cold: Social Networks for Doctors

There's Doximity and Sermo, yes, but that's about it. Plus, while they let physicians connect with, securely message and pose questions to each other, they don't connect physicians to current or prospective patients. At a broader level, though, it may not matter. Physicians tend to shy away from social media, in large part because the risks associated with healthcare social media are broad, ranging from HIPAA to reputation management. It's a shame, too, because patients are all over social media, and they often get bad health information as a result.


Cold: Electronic Health Records

Thanks to meaningful use, EHR implementation has, for the most part, already happened, Wang notes. It's therefore a mature market – and a crowded one, with several hundred vendors (from boutique shops to the $1.7 billion Epic Systems) in the United States alone. Startups very well may be tempted to dip their toe in the water; poor usability, workflow and interoperability suggest that the EHR market is poised for disruption, as do reports indicating that 40 percent of practices want to switch EHR vendors. Incumbents don't go down easily, though – even if, as Stoakes says, today's EHR systems are "still completely broken."


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Healthcare IT: The Real (and Hidden) Costs of Ownership

by System Administrator - Tuesday, 10 March 2015, 11:04 PM


Healthcare IT: The Real (and Hidden) Costs of Ownership

In this whitepaper, we argue that traditional models for estimating HCIT costs are inadequate and overlook several business-critical variables. Our intention is not to provide a comprehensive TCO model, but to expose and examine the operational considerations that most TCO models fail to recognize or account for.


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Healthcare On-Demand

by System Administrator - Thursday, 23 April 2015, 7:35 PM

Healthcare On-Demand, Airbnb Style


If healthcare is becoming “cashified” as I previously discussed, and I am buying healthcare services on my own – I want an experience like Airbnb.

The realization came on a flight back from San Diego. We had just met with a potential investor who was incredibly interested in our startup, but who ultimately balked when he learned how long it takes health systems to make purchasing decisions. True enough, but a little oblique of our actual business model… Ah rejection, like a pair of fuzzy bunny slippers.

Anyway, I was ruminating on the challenges the healthcare industry has in accurately quantifying and measuring outcomes. May seem like a weird thing, but as a company with so much vested in price transparency and otherwise helping consumers make smart purchasing decisions… well, it’s kinda a big deal. All of a sudden, it occurred to me. We’ve got this all wrong.

We will NEVER be able to effectively measure outcomes. We may do better in some areas than others, namely those where feedback is immediate and the consequences severe, like surgeries. Even here, it’s doubtful that we will do much better than just looking at the total number of specific procedures performed by different providers and facilities over a specific time-frame.

If we DO figure it out, it’s going to take 10 years, and no one will understand how to interpret the data, least of all the average consumer. Furthermore, nearly every doctor in America will fall within one standard deviation of every other doctor. Why? Because that’s the kind of country we live in (you know, that place right between a warm cuddle and an obscenely frivolous lawsuit). And, it may even be true. When you factor in the rigorous educational and training requirements, I suspect there is far less deviation between doctor quality than among other ranks of professionals. Sure, the Butcher of Seville is out there, but I doubt he’s going to reveal himself in the resulting gold-star system the industry eventually concocts. (Psst, spoilier alert: everyone’s a 4.7 out of 5)

Mind you, none of this pertains to the actual insight, which is – consumers don’t think this way.

I had just recently used Airbnb for the first time, and the whole experience was fresh in my mind. What an odd concept – that people flying to another city will pay money to stay with a total stranger. Actually, I think that was my thought when I originally heard about Airbnb a year or two ago. Given more recent financial developments, my perspective has evolved to, “sheer genius!”

In all seriousness, Airbnb is a genius display of how consumers evaluate and make decisions. After all, who in their right mind would place their life in the hands of a total stranger using 5 or 6 data points? Uh, last I checked Airbnb is tearing it up, so apparently I’m not the only one.

But really, is Airbnb a good comparison to how we make decisions about our healthcare providers? I’ll give you that one. We are actually infinitely more sophisticated and discerning in picking a couch to crash on then our “medical-centered home” provider, for instance.

Having helped build a medical practice from 0 to over 10k patients, I can tell you that the process an average person goes through in selecting their doctor… scratch that. There is no process. It’s as random as choosing the teller we see at the bank. We stand in line and wait until there’s an open window, and we go where we are told.

At least that is how it has been done as long as we have been operating under a fee-for-service system, or one which is dictated by the rules of CMS and private insurance providers. If you remove the shackles of the continuously “stratisfying” and confusing array of insurance and provider networks, along with their arcane set of indiscernible rules, it becomes incredibly simple to reimagine a better way of doing things.

But who am I kidding? I didn’t reimagine anything. I just took a look at Airbnb and said, “hey, why can’t we do that?”

If healthcare is becoming “cashified” as I previously discussed, and I am buying healthcare services on my own – I want an experience like Airbnb.

If one of my daughters has a sore throat, for example, I want to tap into the list of providers in my local market willing to provide a “sore throat/strep visit” for a cash price. I want to be able to sort them based on a few different variables – price, distance, availability, customer ratings. I also want to see pictures of the office, the providers, and the staff.

I don’t expect these doctors to bid on price, because price is only one attribute I value. For the same reason, I wouldn’t expect every available bed in Boston to go for $122. In fact, last time I looked, I could find something from as low as $45 to as high as $400 per night. Why the variance? Of course this is obvious, but I’ll humor you. One place is a gorgeous brownstone in South Boston, another is a broken futon in what appears to be a derelict dugout in Newton. And is there a market for both? You betcha.

On Airbnb, people set their own prices, but of course the market quickly helps them learn how to adjust that price to find an appropriate equilibrium of demand.

The exact same rules apply to healthcare. For instance, I may be willing to pay $5 more for one doctor over another based on proximity to my house. I also may have a preference for free-standing offices over strip malls, gold painted walls vs. white, friendly smile vs. stick-in-the-mud.

The bottom line is that the market should be setting the price, not insurance companies, and most definitely not the federal government.

Offices will quickly learn that same day cancellations represent opportunity. Because in all of healthcare, there is nothing more valuable than an open appointment right now. This is something the airline industry has mastered, and something a good colleague from a large health system has stressed to me on multiple occasions – healthcare, like the airline industry, is the business of putting asses in seats. I could not agree more.

In fact, when doctors list the services that they are willing to provide for a cash price, they should also have the opportunity to set automatic triggers. For example, my list prices are X provided appointments are scheduled two weeks or more out. If I have an available slot that remains open, automatically increase the price of the visit by 25% during the next week of availability. If it’s still open a week out, go ahead and increase the price another 25%. Finally, If my appointment is still open the morning of, bump it up another 50%. Why? Because it’s fair, and there’s a market for it.

Well run offices with courteous staff and doctors with great bedside manner will start to differentiate themselves in the market, and we will reward them accordingly. And how will we decide who’s doing a great job? It will be based on the reviews of verified patients with closed-loop transactions.

In other words, the data will be real and credible. This is precisely why I am comfortable staying at a stranger’s house based on the feedback of only a handful of reviews. By comparison, to generate the same level of confidence from unverified customer reviews on sites like Yelp or Amazon, I’d probably need to increase the sampling size by a factor of 100, and even then, I’d still be suspicious. (Seriously, how does this Doug Johnson from Mumbai get around to so many different restaurants?)

While there are a number of companies leaning towards the Uber model for on-demand health services, we are much bigger fans of the Airbnb approach, not the least of which because we see cash-based services as an emerging business line for otherwise stifled healthcare providers.

This approach allows doctors and provider organizations to continue doing what they are doing (picture hamster wheel), while gradually exposing more and more availability to a higher-value market segment, until they eventually cast aside the yoke of insurance. Kind of like one of my partner’s friend whose full-time job has become renting out his rent-controlled bedroom in San Francisco to Airbnb’ers. I won’t tell you what he does with his day, but I’m quite certain he feels liberated.

Seriously, just imagine… 

David is the Founder and CEO of Medlio, healthcare’s only social CRM – a new technology designed to help providers better engage with their digitally-empowered customer base. He has more than 14 years of health technology experience as both an independent consultant and entrepreneur. During this period, he started and ran a primary care medical practice for 8 years, which gives him unique insights to the front-line challenges faced by provider organizations. 


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Healthcare Ransomware Protection

by System Administrator - Thursday, 13 October 2016, 3:14 PM

10-minute Guide to Healthcare Ransomware Protection

by Xtium

When dealing with mission-critical — or in the case of healthcare providers, “life-critical” — systems, data loss and time loss from cyberattacks and ransomware are unacceptable. While most companies have implemented some type of formal backup or disaster recovery plan, many are regrettably learning too late just how unprepared they are.

 As a result — under the pressure of an attack — they are not able to recover their production systems without significant cost, anguish, and embarrassment.

Please read the attached guide.

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Healthcare Transformers

by System Administrator - Thursday, 7 August 2014, 5:57 PM

StartUp Health Reveals New Class of 14 Healthcare Transformers


StartUp Health, a global startup platform accelerating health and wellness innovation, today announced from the Cleveland Clinic Medical Innovation Summit the addition of 14 digital health companies to its exclusive long-term coaching program and community.

The selected class of 14 “healthcare transformers” represents an experienced group of entrepreneurs focused on building sustainable digital health companies across a broad spectrum of innovation from home healthcare, genomics, aging, sensors, patient and physician engagement, mobile health and wellness, nutrition analysis, concierge medicine, care coordination and price transparency. StartUp Health received more than 1,200 applications from 22 different countries for this class.

A Three-Year Structured Program


StartUp Health believes a three year structured program is the best approach to transforming healthcare to support and promote entrepreneurs with ongoing inspiration, education, and access to customers, capital, and other critical resources so that innovation and growth can occur more quickly.

The three year location- and stage-agnostic program focuses on customer development, capitalization and fundraising, scaling team and talent, and streamlining operations to best position startups for growth.

One of the key differentiators is StartUp Health’s long-term focus on connecting health and wellness startups with customers, pilot programs, strategic capital partners, and the critical resources designed to help Healthcare Transformers achieve 10x equity value for their businesses.

As of October 2013, 46 StartUp Health companies have raised a total of $106 million in funding.

The new class of StartUp Health Companies and Healthcare Transformers include:

Point of Care 360

Sector Focus: Patient Engagement; Physician Engagement; Point of Care Reference

The @Point of Care360™ platform provides a streamlined practice-based tool to allow for the delivery of content at the clinician’s fingertips at the time it is acutely needed, enabling better decisions, better outcomes, and better care.


Sector Focus: Genomics; Wellness; Behavior Change

1EQ leverages both genetics and lifestyle information, provided through wireless devices and mobile apps, to produce a more comprehensive health picture an actionable steps for its users to live a better and healthier life.

Adhere Tech

Sector Focus: Medication Adherence

A patented smart pill bottle to improve medication adherence. The bottle automatically determines the amount of medication in real­time, and wirelessly transmits this HIPAA­compliant data to the cloud via Verizon network. If a patient hasn’t taken his/her medication, AdhereTech reminds the patient via phone call or text message, as well as via on­bottle lights and chimes.

The company has secured trials with research institutions and pharma companies.


Melissa Manice, Ph.D., MPH is on a mission to give kids the tools to change their health. CoheroHealth has created AsthmaHero, a mobile solution for kids with chronic asthma, incorporating an inhaler sensor and mobile application to track real­time adherence and mobile spirometry through an engaging, gamified patient interface.


Sector focus: Genomics; Big Data

Fabricio F. Costa, Ph.D., and Marcelo P. Coutinho, MD, MsC, are on a mission to facilitate information exchange about genetic and rare diseases to translate the latest advances into effective clinical interventions. DataGenno (@datagenno) is an online medical information company created to be the one­stop source of information on genetic diseases and syndromes, connecting both clinical and molecular aspects of genetic diseases in a fully interactive environment.


Sector focus: Wellness; Nutritional Analysis

Edamam, founded by serial entrepreneur Victor Penev, is organizing the world’s food knowledge. The company provides cost­effective, on­the­fly nutritional analysis and diet labeling to businesses and consumers through its proprietary semantic food and nutrition knowledge database and natural language processing algorithms. Edamam aims to become the default digital nutrition engine of the web.

Gene By Gene

Sector focus: Analytics; Big Data; Genomics

Gene By Gene, Ltd. is a leader in genetic DNA testing with ancestry and medical solutions. Founded in 2000 as the world’s first company to develop consumer DNA testing for ancestry and genealogy applications, Gene by Gene provides a comprehensive approach to diagnostics tests, including AABB certified relations tests, genome sequencing, data management and computational analysis. Gene by Gene recently acquired StartUp Health company Arpeggi.


Sector focus: Concierge Medicine; Home Health

Sam Zebarjadi, Sahba Ferdowsi, MD, and Nafis Zebarjadi are on a mission to make it easy for anyone to receive access to a doctor with the click of a button. The Medicast (@medicast) web and mobile platform provides consumers with 24­hour on­demand medical services, including delivering high quality, compassionate doctors directly to a patient’s home, office or hotel.


Sector focus: Home Health; Patient Relationship Management, Concierge Medicine, Telehealth

Mark Hadfield, a serial entrepreneur, is on a mission to revolutionize the home care market and simplify how doctors and patients connect online. Ondello(@ondellortc) delivers WebRTC­based software services that enable healthcare providers to seamlessly communicate in real­time with patients through in­context chat, video and voice.


Sector focus: Patient Relationship Management; Home Health; Wellness

John Grispon, Ted Spooner, and Jason Leighton are on a mission to increase patient engagement in physical therapy for more effective PT treatment and reduced readmissions. Respondesign’s flagship product, FitWorld (@fitworldapp), is a Kinect­based rehabilitation therapy platform that targets all segments of rehab from falls prevention and disease management to orthopedic and pulmonary rehab. The platform also enables therapists to deliver an engaging, personalized program that includes patient monitoring and clinician reporting for in­clinic and at home usage.


Sector focus: Mobile Health; Patient Engagement; Wellness

John Moore is on a mission to ensure that patients’ emotional well­being is seen as equally relevant to their clinical health as any biometric measure. RxApps(@rxapps) supplements standard management of chronic illness using customizable text message prompts to track patient health, experience, and behavior metrics that influence outcomes.

Sense Health

Sector focus: Mobile Health; Patient Engagement; Patient Relationship Management; Home Health

Stan Berkow, Brad Hammonds and Paul Biancaniello are on a mission to engage people with their health and improve patient support. Sense Health(@sensehealth) unlocks the potential of mobile health support for patients by giving healthcare professionals a mobile platform to easily create, deliver, and monitor interactive support plans for their patients in between appointments.


Sector focus: Hands­free Medical Care; Sensors and Tracking

Jesús Pérez­Llano (@jesusperezllano), Enrique Muñoz, Daniel Calvo, Gerardo Caballero and the rest of the TedCas team are on a mission to unleash the potential of touchless devices such as Kinect or LEAP inside the health sector. TedCas (@tedcas), powered by Wayra and Sodena, allows doctors to control and manipulate software through gestures and voice commands, without touching, saving time and reducing potential infections.

Yingo Yango

Sector focus: Wellness; Mobile Health; Employer Health; Patient Relationship Management

Marty Jaramillo (@martyjaramillo) and his team are on a mission to unite the highly fragmented health/wellness industry. Yingo Yango (@yingoyango) is a white­label, stand alone, mobile patient engagement platform that integrates ecosystems of care. The platform is designed to maximize long­-term employee/patient engagement, reduce readmissions, as well as brand clients as health minded, patient centric, and caring organizations. The low cost “connecting the dots” solution is designed for corporations, carriers, and providers.

StartUp Health Reveals New Class of 14 Healthcare Transformers by Jasmine Pennic



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Healthcare's Future-Ready IT Platforms

by System Administrator - Monday, 1 September 2014, 6:42 PM

Building Future-ready IT Platforms

To keep pace with healthcare’s evolving landscape, IT systems must be scalable, adaptable and secure.

Few industries face the magnitude of change that healthcare is undergoing today. Accelerated in the U.S. by sweeping and ongoing reforms, a radical transformation is taking place globally, driven in large part by the well-documented rise in chronic diseases and aging populations. These demographics, combined with rising costs, are colliding with fiscal realities, causing healthcare spending to consume an ever-increasing portion of the
world economy, widely seen as unsustainable.

Please read the attached whitepaper.

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Healthy Conflict Resolution for Physicians

by System Administrator - Thursday, 22 January 2015, 1:19 PM

Healthy Conflict Resolution for Physicians

By Catherine Hambley, PhD

We can't get away from it — almost everywhere you look, from the medical office to the hospital to home, wherever people are involved, conflict can erupt. So it is not the presence of conflict that is critical; it is the ability to resolve it in a productive and healthy manner that matters most. "Productive" means that the resolution leads to positive change. "Healthy" means that we are preserving, or even improving the relationship. Both are important. And if conflict is left unresolved, much like a wound that goes untreated, it can fester, grow, and lead to more damage.

The good news is that it is relatively easy for a physician to learn effective conflict resolution skills. Of course the challenge is putting them into practice. The more you practice, the easier it becomes, and, like so many other skills, the better you get at it. As we explore some basic conflict resolution skills, it is helpful to understand what happens to people during these challenging encounters so that we can develop successful strategies.

Our brains are wired to quickly and effectively attend to potential threats in our environment. When conflict arises, for whatever reason, it causes people to feel a sense of threat. Emotions get triggered, our flight or flight systems goes into action, and our limbic system gets activated. The stronger the feeling of threat, the less able we are to think clearly and rationally, see the situation from our staff's or patient's perspective, problem solve, and collaborate. Our executive brain starts to shut down right at the time when we need it most. With this scenario in mind, here are five steps to healthy conflict resolution:

1. Self-awareness

As a physician, it is important to stay tuned into what is going on for you emotionally. The earlier you are aware of getting emotionally triggered, the better able you are to recognize and manage your emotions in a productive manner. And the more self-aware you are, the better you can identify the types of experiences that tend to be your triggers. This allows you to proactively prepare for managing these stressful situations in a positive manner.

2. Self-management

Before you even attempt to engage in conflict resolution, you need to be in a state of mind that is most conducive to this process. That means calming your emotions so that you can be open to another person's perspective. If you are able to catch your feelings before they get too strong, then you can name the feeling, which often has the effect of lessening its intensity. Other strategies to manage your emotions include taking a few slow deep breaths, modifying negative, disruptive thoughts (for example, if you hear yourself having thoughts like "always" and "never," you know you might be seeing things as black or white), and reminding yourself that there is more than one perspective of the situation.

3. Get curious

Rather than looking for who might be right (usually we are convinced that we are the right ones) and who might be wrong (must be the other person), look for differing perspectives. ASK rather than TELL. Be genuinely interested and curious about how the other party perceives the situation and about what matters to them. Asking about and acknowledging the other person's point of view is one of the fasted and easiest ways to de-escalate conflict. Listen to understand — rather than listening so you can come back with a quick response.

4. Appreciate differences

When we remove blame from the equation, then it is easier to understand differing perspectives. Just like your emotions get triggered during conflict, be aware that you can unintentionally trigger negative emotions in others. Understand that because no two brains are alike, the emotions you are experiencing may be different from the other person's — and vice versa. Notice not just what he is saying, notice what feelings are being communicated nonverbally. Be aware of what you might be communicating nonverbally.

5. Focus on one issue at a time

When you are in a conflict situation and your emotions are triggered, it can be easy to start piling on all the things that you are upset with this person about. Stick to the issue at hand; avoid blame, criticism, and attack. ASK — Seek the other person's perspective; CLARIFY — so you are sure you have it right; ACKNOWLEDGE — share your understanding about how the other person sees it, even if you don't agree with that perspective. Acknowledge her feelings as well. Then share your perspective as objectively as possible.

Using these key physician communication skills will result in healthier and more productive conflict resolution — so that you can facilitate positive change and improve your relationships — with staff, with patients, and with medical colleagues.  

Catherine Hambley, PhD, is an organizational psychologist who leverages brain science to promote effectiveness and positive change in her work with organizations, teams, and leaders. In addition to her extensive background in healthcare, she has worked across a wide array of industries, from Fortune 100 companies to non-profit organizations. She may be reached at or


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by System Administrator - Thursday, 9 October 2014, 1:07 PM


Care providers are under increasing pressure to do more in less time. This eBrief presents three strategies and example case studies to help your clinicians achieve time savings by increasing communication workflow efficiencies.


A Preview of the Topics:

  • Don’t play phone "Tag — you’re it"
  • Stop checking the EMR for test results
  • Forget the paper on-call schedules

Please read the attached whitepaper.

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HHS releases updated Meaningful Use rules

by System Administrator - Tuesday, 6 October 2015, 8:16 PM

Breaking News: HHS releases updated Meaningful Use rules

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Hospital CIOs: How to approach hiring your staff

by System Administrator - Friday, 1 August 2014, 11:30 PM
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Hospital Disaster Recovery

by System Administrator - Thursday, 25 June 2015, 9:06 PM


Hospital Disaster Recovery

Hospitals facing disasters, from IT outages to crippling or even deadly weather to mass casualty events, must be ready to operate--all systems go--regardless of the situation at hand. Preparation and recovery, however, is not an overnight process. It can have serious financial repurcussions, as many executive can attest. It takes thoughtful planning, training and preparation.

This eBook will discuss:

  • Multiple tactics, from tools to training, to prepare your organization for disaster
  • How to weather an IT outage while maintaining high-quality patient care
  • The keys to effective patient triage in the midst of chaos
  • What steps to take to quickly resume operations and minimize financial impact
  • The pros and cons of business interruption insurance and the pitfalls of relying on government aid

Please read the attached whitepaper.

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Hospital Information System Crash

by System Administrator - Saturday, 2 August 2014, 2:33 AM

4 Things to Know in Case of a Hospital Information System Crash

Written by Bob Herman

It's a nightmare any hospital hopes to avoid: a crash or prolonged outage of its central information system. As hospitals and health systems continue to transition to an all-electronic landscape, though, the possibility of an information system crash is just one unexpected disaster away from occurring. 

Michael Ward, director of information services at Anderson Hospital in Maryville, Ill., gives four considerations to shore up a contingency plan in case a hospital's information system hits a snag.

Continue reading

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Hospital leaders must overcome resistance and disrupt their own organizations

by System Administrator - Thursday, 19 February 2015, 3:57 PM

Hospital leaders must overcome resistance and disrupt their own organizations

by Lynn McVey

The traditional theory of disruption calls for outsiders to shake up an industry. A recent survey of 150 healthcare executives revealed "more than 50 percent felt healthcare is ready for disruption," according to Harvard Business Review.

However, nearly two-thirds of respondents said resistance was the biggest hurdle to innovation, according to the report. Inefficient or outdated analytics and processes were also cited. "The overwhelming sentiment was that the impediments to change are mostly internal," Paul Merrild wrote in HBR. "Overcoming such challenges requires intrepid leadership."

Respondents to the survey said they scan widely for models of executives who have successfully disrupted their own organizations. "When we asked which companies' healthcare executives most admire, the top choice wasn't Mayo, Cleveland Clinic or any other blue chip healthcare institution," wrote Merrild. "Top choice was Apple: the tech giant who cannibalizes its own products and promotes disruption before being overtaken by it."

We say "hindsight is 20/20." If we had the chance to do it over again, wouldn't we have chosen an electronic medical record for all facilities? We could have been years ahead of where we are now in terms of Meaningful Use, standardizing and sharing information. Yes, this country is proud of its free market but I question whether healthcare should remain a part of that market, especially given what we now know about the fraud, abuse, unnecessary testing and corruption in the industry.

I had the absolute pleasure of speaking to Chuck Lauer on the phone recently. Lauer published Modern Healthcare magazine for many years and now is a frequent consultant. He reminds me of my father, a former Marine with integrity, honesty and a passion for hard work. If you have read any of Lauer's published works on the current fiasco in healthcare leadership, you can immediately sense his commitment to commit. About 2014's soaring 20 percent resignation rate among hospital CEOs, he said, "I and a number of other observers think the data reflect a lack of will and commitment. Faced with a once-in-a-lifetime opportunity to overcome the silos, inefficiencies and quality problems plaguing American hospitals, more and more CEOs are making a beeline for the exit, hefty retirement packages in arm."

My dad, Chuck Lauer and others from "The Greatest Generation" are not afraid of the hard work needed to fix this healthcare mess. To survive, it is not business as usual. A manager just asked me to pre-approve eight hours of overtime for a project tonight. A traditional executive might trust this manager and blindly approve it. An evidence-based executive asked for the details. The project added up to only three hours, so I only pre-approved three hours. An hour later, he walked back into my office to proudly say he could break up the project into several nights, so he wouldn't need any overtime after all.

Years ago, I replaced a manager who told me on his way out, "This department runs itself." What I heard was, "This department is padded so that I have less work to do." I used six national key performance indicators (KPIs) to quickly locate and eliminate several inefficiencies which added up to $50,000 per month. Because traditional management does not use comparative KPIs to gauge managers' performance the administration never knew it wasted $12 million over the 20 years the manager oversaw the department.

We may be called "micro-managers" when we drill down for evidence, but I call that my job.

Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center, an acute care, 230-bed hospital in New Jersey.


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Hospital provides patient access to health information at the bedside

by System Administrator - Thursday, 20 April 2017, 6:27 PM

Hospital provee acceso a EHR al costado de la cama del paciente

Hospital provides patient access to health information at the bedside

by Kristen Lee

University of Colorado Health is securely providing patient access to health information at the bedside. Experts detail how they are able to achieve this and engage patients.

The healthcare industry has been trying to solve the problem of patient access to health information for a while now. Solutions to this problem have cropped up in the form of patient portals, mobile apps and more.

Although providing patient access to health information while patients are outside the hospital is important, equally important is providing that information while patients are in the hospital.

The University of Colorado Health (UC Health) in Denver decided to tackle this specific problem and provide hospital patients with their health information -- including lab results, test results and vital signs -- in real time, at their bedside. To accomplish this, the hospital uses Samsung tablets and Samsung's Knox Custom Configurator, said Trevor Smith, senior account manager of strategic accounts at Samsung.

"We use Knox specifically to help us in delivering content on a tablet and then … make those [tablets] secure [by] wiping them completely," said Ed Horowitz, senior multimedia developer of clinical informatics at UC Health. He explained that in addition to providing patients with their real-time health data, they can also download apps -- such as Netflix and Facebook -- onto the tablet for entertainment.

"We worked specifically with Knox to develop a … much more specific app where we can wipe any data and wipe anything in there but then have the tablet restored almost immediately to its image with the apps and the system that we want on it," Horowitz said.

Kyle Toburen, senior engineer of desktop and mobility integration at UC Health, describes the Knox system as a mobile device enrollment program rather than mobile device management, although the system falls under the umbrella of managing mobile devices.

"[Knox] applies applications and policies and profiles to a device," he said.

Balancing patient access and security

UC Health's custom Bedside app resides on top of Knox's Custom Configurator, which allows the hospital to provide patients access to health information in real time while maintaining security and HIPAA compliance in several ways:

Connection to the EHR -- Patients are able to view their health data in real time on a tablet because UC Health's custom Bedside app and Knox connect to the hospital's EHR -- Epic -- but no EHR data is stored on the tablet.

"It makes the patient much more compliant when they're active on day one with what's going on."

Ed Horowitz | senior multimedia developer of clinical informatics at University of Colorado Health

Toburen explained that the connection to Epic's server and to that specific patient's medical record is made by first scanning the patient's Epic record barcode.

"Once you've done that, you've created that connection between the tablet app and Epic and then once the patient goes into the … Bedside app [on the tablet] they can see all their information," Toburen said, adding that once the patient has been discharged, that connection from the tablet and the Bedside app to the patient's medical record in Epic is broken and that patient's record cannot be accessed from that tablet and Bedside app anymore.

"If somebody launched Bedside on the tablet it would act like it's waiting for a new patient," he said. "It's waiting for a new barcode."

Secure wipe, factory reset -- UC Health is also able to securely provide patient health data in real time because of the secure wipe and factory reset features Knox provides.

"We did need that solution that we felt completely wiped out any trace of [the patient's] stay on there and basically brought it back to … factory settings at some level and everything was wiped out," Horowitz said.

Once the secure wipe is done the tablet is restored to its default settings.

"That's where you don't have to worry about maybe [someone's] injected some sort of malicious code and it's working in the background," Toburen said. He added that if there is ever any concern of that happening, UC Health can wipe the device clean. Then, "Knox reapplies all the settings we want."

Tablets connected to external network -- Toburen explained that, as an added security measure, tablets are connected to an external network which allows patients to essentially do whatever they want -- like download entertainment apps -- on the tablet provided to them without compromising hospital security.

Knox also applies some restrictions, Toburen said. "Users don't have the ability to go in and change many of the settings. They can't choose a different network."

The importance of providing health data securely

Providing patient access to health information better engages them in their own healthcare, Horowitz said.

"It makes the patient much more compliant when they're active on day one with what's going on. It reduces the anxiety and stress level."

Horowitz added that providing patients access to their health data also helps nurses and doctors provide care more efficiently.

If a patient has all the information he needs or may want to know in front of him, Horowitz said, he won't call the nurse or doctor as often, which allows the healthcare staff to focus on other areas of the patient's care. 

Next Steps



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Hospital tones down alarms to reduce fatigue, enhance safety

by System Administrator - Monday, 16 February 2015, 1:01 AM

Hospital tones down alarms to reduce fatigue, enhance safety

Article by: JEREMY OLSON | Star Tribune 

Excessive noise can slow or prevent responses to real emergencies

After a night shift at Abbott Northwestern Hospital, Todd Ostlund would go home and switch off his phone ringer and anything else mimicking the many, many alarms a nurse hears while on duty.

And still, on many nights, he’d be roused from sleep by a “beep, beep, beep” in his dreams.

“I’m never having peace,” he said.

Medical device alarms play critical roles in a hospital — to signal trouble with a patient’s vital signs or medical equipment, and to draw caregivers to the bedside in time to help. But too often, alarms have been nuisances — set off by patient movements that cause their pulse to spike briefly, or by a momentary kink in an IV line, or patients simply scratching their noses and bumping the blood oxygen monitors on their fingers.

The resulting problem, known as “alarm fatigue,” can prevent nurses from responding to real patient emergencies, with fatal results. The Joint Commission, the nation’s hospital accrediting body, attributed 80 deaths and 13 serious injuries to alarm-related failures in a recent four-year period, and in 2013 required hospitals to commit to preventing alarm fatigue.

Now, a study from one of Abbott’s intensive care units suggests that less, indeed, can be more.

The unit switched the default settings of its pulse-rate alarms from overly conservative thresholds of high and low beats per minute, and to avoid duplication with alarms that go off for related cardiac issues.

The number of pulse rate alarms dropped 76 percent within six months — but Abbott’s nursing leaders found no resulting incidents of patient emergencies being missed. If anything, nurses responded even faster to the remaining alarms because they were less likely to be false.

The goal is to avoid any alarm “that isn’t going to prompt an urgent response,” said Dr. William Dickey, a hospitalist at Abbott who tends to patients throughout the hospital. “It’s the difference between bad and absolutely urgent.”

Ostlund noticed the change on his nights in that unit. There were far fewer alarms breaking his concentration while he tried to complete a medical chart, or pulling him from one patient to another who wasn’t in imminent need of help.

“It relieves some of the stress of being a nurse,” Ostlund said. The seven-year veteran added that he has seen colleagues leave the profession in part due to the raucous environment of a hospital.

Mayo’s results

Efforts to ratchet back alarms reflect the ebb and flow that emerges in many aspects of medicine. High-resolution CT imaging machines, for example, were broadly used until doctors discovered that their high cost and low-level radiation exposure could outweigh their diagnostic benefits in certain cases.

“Just because there’s a new gizmo on the market doesn’t mean we need to purchase it,” said Dale Pfrimmer, nurse administrator for Mayo Clinic’s thoracic and vascular division in Rochester.

Pfrimmer oversaw a similar study in two Mayo critical care units, and said a reduction in alarms over three months did not result in more emergencies such as Code Blues, when unresponsive patients needed resuscitation.

Such emergencies actually declined, though that might have been coincidental. But the alarms that went off did get the staff’s attention, he said. “You really focus when you do hear those alarms, because now they mean something.”

Missed emergencies aren’t the only danger. Nurses distracted by noise can lose concentration and make mistakes, or can fall behind in their work if they err on the safe side and check every alarm immediately. Patients in ICU care also can have their sleep disrupted.


Relatives tune out, too

The risks, and the concept of “alarm fatigue,” gained broad national attention after the 2007 death of a woman at UMass Memorial Medical Center in Boston. Nurses failed to respond to an alarm indicating that her monitor’s battery needed replacing, and, when her monitor lost power, didn’t know she was having a fatal cardiac arrest.

Alarm incidents have been reported in Minnesota, though they reportedly involved poor staffing and staff training rather than noise fatigue. A baby died in a high-profile 1997 case when poorly trained medical foster care providers turned off an oximeter that could have alerted them to her distress.

The family’s attorney in that case, Chris Messerly, has come to appreciate the issue because his father has been in intensive care.

“I was thinking these same things as I was sitting in there every day for the last week,” he said. “Sometimes [alarms] would go off and no one would come in for, like, 10 minutes.”

Frequent alarms do upset visiting families, especially if they sound severe but caregivers don’t respond immediately, said Dickey, the Abbott hospitalist. On the other hand, some relatives come to understand the issue so well that they start turning off alarms on their own, which can also create hazards, he said.

Abbott has expanded the alarms project to its neuro ICU. In addition to changing the pulse rate parameters of the EKG alarms, the hospital trained nurses in intensive care to clean the monitor lead sites on patients’ skin each day and change the leads because there is research suggesting this reduces false alarms.

Next up are reviews about the frequency of alarms for IV lines. These sometimes go off even when there are temporary kinks preventing the flow of liquid, not real blockages preventing blood, fluids or medicine from getting to patients.

Oximeters, which measure blood oxygen levels, are particularly sensitive to false alarms because they are loosely attached to a patient’s finger. Most blare alarms in four seconds, when waiting 10 or 15 seconds might differentiate between false alarms and real problems.

Then maybe Ostlund and other nurses will get some sleep at home. Ostlund was so happy about the alarms project in the ICU that he e-mailed thanks to his supervisors.

“You’ve got to imagine a constant din,” he said. “Now, it’s just not there anymore.”

Jeremy Olson • 612-673-7744


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How a mHealth outpatient solution cut new-patient visit time 33%

by System Administrator - Thursday, 18 December 2014, 6:10 PM

Webcast: How a mHealth outpatient solution cut new-patient visit time 33%

Learn how Sanger Heart and Vascular Institute, part of Carolinas HealthCare System, leveraged GetWellNetwork Ambulatory on the iPad® to provide patients with condition-specific information, help them understand their care and complete priority care interventions.

Video - Webcast


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How Boston Children's Hospital hit back at Anonymous

by System Administrator - Tuesday, 16 September 2014, 8:29 PM

How Boston Children's Hospital hit back at Anonymous

Hackers purportedly representing Anonymous hit Boston Children's Hospital with phishing and DDoS attacks this spring. The hospital fought back with vigilance, internal transparency and some old-fashioned sneakernet. That – and a little bit of luck – kept patient data safe.

By Brian Eastwood

On March 20, Dr. Daniel J. Nigrin, senior vice president for information services and CIO at Boston Children's Hospital, got word that his organization faced an imminent threat from Anonymous in response to the hospital's diagnosis and treatment of a 15-year-old girl removed from her parent's care by the Commonwealth of Massachusetts.

The hospital's incident response team quickly convened. It prepared for the worst: "Going dark" – or going completely offline for as long as the threat remained.

[ More: 'Anonymous' Targets Boston Children's Hospital ]

[10 mistakes companies make after a data breach]

Luckily, it never came to that. Attacks did occur, commencing in early April and culminating on Easter weekend – also the weekend of Patriot's Day, a Massachusetts holiday and the approximate one-year anniversary of the Boston Marathon bombings – but slowed to a trickle after, of all things, after a front-page story about the incident ran in The Boston Globe.

No patient data was compromised over the course of the attacks, Nigrin says, thanks in large part to the vigilance of Boston Children's (and, when necessary, third-party security firms). The organization did learn a few key lessons from the incident, and Nigrin shared them at the recent HIMSS Media Privacy and Security Forum.

As Anonymous Hit, Boston Children's Hit Back

As noted, the hospital incident response team – not just the IT department's – planned for the worst. Despite that fact that the information Anonymous claimed to have, such as staff phone numbers and home addresses, is the stuff of "script kiddies," Nigrin says Children's took the threat seriously.

Attacks commenced about three weeks after the initial March 20 warning. Initially, the hospital could handle the Distributed Denial of Service (DDoS) attacks on its own. Anonymous changed tactics. Children's responded. The hackers punched. The hospital counterpunched. As the weekend neared, though, DDoS traffic hit 27 Gbps – 40 times Children's typical traffic – and the hospital had to turn to a third-party for help.

The attacks hit Children's external websites and networks. (Hackers also pledged to hit anyone linked to Children's – including the energy provider NStar, which played no role in the child custody case at all but sponsors Children's annual walkathon.) In response, Nigrin took down all websites and shut down email, telling staff in person that email had been compromised. Staff communicated using a secure text messaging application the hospital had recently deployed. Internal systems were OK, he says, so Children's electronic health record (EHR) system, and therefore its capability to access patient data, wasn't impacted.

[ Research: Healthcare Security Brings Challenges, Opportunities, No Big Surprises ]

In contrast to this internal transparency, Children's, at the urging of federal investigators, didn't communicate anything externally. Nonetheless, word got to The Boston Globe, which ran its front-page story on April 23.

Nigrin, again, prepared for the worst. He didn't have to. After the article came out, the Twitter account @YourAnonNews took notice, urging hackers to stop targeting a children's hospital. Attacks continued, but at a much smaller clip.

6 Quick Tips for Beating Back Hackers

In reflecting on the Anonymous attack, Nigrin offers the following security lessons that Boston Children's learned.

  • DDoS countermeasures are crucial. "We're not above these kinds of attacks," Nigrin says.
  • Know which systems depend on external Internet access. As noted, the EHR system was spared, but the e-prescribing system wasn't.
  • Get an alternative to email. In addition to secure testing, Children's used Voice over IP communications.
  • In the heat of the moment, make no excuses when pushing security initiatives. Children's had to shut down email, e-prescribing and external-facing websites quickly. "Don't wait until it's a fire drill," Nigrin says.
  • Secure your teleconferences. Send your conference passcode securely, not in the body of your calendar invite. Otherwise, the call can be recorded and posted on the Internet before you even hang up, he says.
  • Separate signals from noise. Amid the Anonymous attack, several staff members reported strange phone calls from a number listed as 000-000-0000. At the time, it was hard to tell if this was related, and it made the whole incident that much harder to manage.

Above all, Nigrin says healthcare organizations need to pay attention to the growing number of security threats the industry faces. "There are far more than we have seen in the past," he says.

This story, "How Boston Children's Hospital hit back at Anonymous" was originally published by CIO .



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How cloud is saving lives

by System Administrator - Tuesday, 28 October 2014, 3:32 PM

How cloud is saving lives

Scientists and enterprises are turning to the cloud for HPC
The cloud is aiding projects to fight malaria and cancer, and helping banking firms simulate the financial health of clients. Archana Venkatraman reports

Please read the attached ComputerWeekly's article


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How do you describe healthcare reform to your patient?

by System Administrator - Wednesday, 23 September 2015, 7:29 PM

How do you describe healthcare reform to your patient?

By Dr. Gary Wietecha, Physician Director of Clinical Content, NextGen Healthcare

“Google it” is not the best answer to give when a patient asks you about healthcare reform.

But when you do Google “healthcare reform,” well, of course, you get lots of answers. And none of them that useful as an immediate aid to explaining health care reform to your patient.

A “one liner” health care reform definition here:  focuses on health insurance: “The Affordable Care Act (ObamaCare) increases the quality, accessibility, and affordability of health insurance.” But you’ll have to tell your patient more than that.

Before you do, pause and consider: A large percentage of our population will not be immediately affected by health care reform. Because a major portion of The Affordable Care Act is designed primarily for Americans who don’t have health insurance and seek health care only when acutely ill. You know your own patient panel the best and whether or not they are primary stakeholders for The Affordable Care Act.

What else?

Here are two other points that might help.

First, consider using “Triple Aim” as a concept and living definition for health care reform .

Created by Institute for Healthcare Improvement (IHI) President Emeritus and Senior Fellow Donald M. Berwick, MD, MPP, The Triple Aim Initiative is a three part strategy to optimize performance of the American health system. It goes like this: 1) improve the patient experience of care (including quality and satisfaction); 2) improve the health of populations; 3) reduce the per capita cost of health care. And that, on a macro scale, is really what health care reform is all about.

Second – provide patients with a time frame that might help them put their arms around the scope and scale of health care reform in America: The Patient Protection and Affordable Care Act – which drives health care reform across the nation – was signed in 2010 and will take until 2022 before all of its provisions are rolled out. A 12-year passage.

The Journey: Part of explaining health care reform

Remember the oldest ever doctor joke? “This will hurt you more than me!”

Not this time. Health care reform requires a long (multi-year, as I just pointed out) and difficult journey. And it’s a much more difficult journey for providers than patients. It’s OK to tell your patients that health care reform is making the practice of medicine much more challenging these days.

Patients will “get” what it means when you share with them that part of health care reform requires more precise clinical documentation by your staff; extra, ongoing training on new EHR and practice management software systems; and getting used to new clinical workflows that improve outcomes and reduce costs. Patients should “get” one more thing… their role in health care reform. Their journey to benefit from health care reform.

Increased patient responsibility is also part of explaining health care reform

As you dialog with patients about health care reform, you’ll do each of them a favor if you reinforce the idea of active healthcare. I like the term because it implies proactive patient behavior. Passive healthcare is reactionary; active healthcare is healthcare in motion – always seeking “better.” Active healthcare requires sustained patient participation in all matters affecting their physical and mental well-being.

Finally, tailor and scale your explanation. Keep in mind the level of sophistication each of your patients has as you explain elements of health care reform. What would you want to know about health care reform if you were the patient? And what one patient wants to know could differ greatly from what other patients may want to know, or even have the capacity to understand.

The patient encounter is health care reform

These days, patients participate in health care reform every time they see you; patients originate the mountains of structured and unstructured protected health information (PHI) now forming a mega foundation of “big data” accumulating in registries and health information exchanges (HIEs) across the country.

It’s the strategic use [sharing and analysis] of this “big data” – to provide more insightful answers and the potential to drive better clinical decision making – that represents the nirvana of health care reform in America.

And if you’ve gotten this far explaining health care reform to your patient… you’re waiting room is probably full.



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How Hiring Right (or Wrong) Has a Direct Impact on Clinical Outcomes

by System Administrator - Wednesday, 28 January 2015, 5:08 PM

How Hiring Right (or Wrong) Has a Direct Impact on Clinical Outcomes


A recent study finds that more experienced nurses deliver better patient care and shorten lengths of stay. But as more experienced nurses leave organizations for better opportunities or retirement, hospitals must hire new, less experienced nurses or temporary contract nurses. The result can lead to poor patient outcomes.

For the eBook, we spoke to nurse leaders across the country to examine the top challenges hospitals face with nurse staffing and how to overcome them.

Download to learn:

  • Hiring strategies to ensure you find the right nurse to fit your organization's culture and mission
  • Creative ways to retain and engage nurses
  • How to determine the ideal nurse-to-patient ratio for your organization
  • Success stories from hospitals that implemented policies to help educate nurses and report higher nurse satisfaction and HCAHPS (patient satisfaction) scores

Please read the attached eBook

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How Mobile Technology Can Bring Trauma Relief After Ebola

by System Administrator - Friday, 26 June 2015, 7:22 PM

How Mobile Technology Can Bring Trauma Relief After Ebola

By Nathaniel Calhoun and Elie Calhoun

Nathaniel Calhoun focuses on the intersection of last mile development work challenges, mobile education for poverty alleviation and ecological design. Follow Nathaniel on Twitter @codeinnovation.

The promise of mobile technology is that we can connect the farthest, most remote corners of the globe to the Internet—where a treasure trove of information and applications can be had nearly for free. For aid workers, this technology is proving a powerful, even revolutionary tool.

We hope our new community mental health app will demonstrate a new depth of potential impact.


When we started designing our psychosocial services app for Liberian communities recently ravaged by Ebola, we thought we’d first need to justify the very idea of focusing on mental health in a country facing so many pressing concerns.

The health system in Liberia confronts massive challenges. When hospitals are non-existent or seriously under-staffed, when malaria is endemic and young mothers die during childbirth—it can be tempting to ask people suffering from trauma to simply “toughen up.”

But as we’ve gathered our research and begun strategizing the mobile app, we’ve found prominent and trend-setting evidence that psychosocial support is no longer being neglected in the context of the world’s poor and vulnerable communities. This is a game-changing shift.

Starting this year, the World Bank and Japan are generously funding a multi-layered, multi-year program that specifically targets individuals who worked in traumatizing jobs during the Ebola outbreak. (You can read more about it here.) USAID is exploring the merits of funding similar programs and even the World Economic Forum has convened a Council on Mental Health and Well Being that seeks to put mental health on the economic development agenda.

The challenge, we’ve discovered, will be less about convincing people that low-income countries deserve mental health services —and more about how to provide such a service widely and at low cost.

What’s more, we are challenged to build support within decentralized community health systems—not as an addition to them—so that these kinds of mental health services can be provided locally and sustainably, from now on.

This is where mobile health technology can be a powerful tool.

Current programs focus on providing one-on-one mental health services—the model for psychosocial services in rich and industrialized countries. Such services are limited by the presence, cost and availability of trained mental health professionals.


Image courtesy of Second Chance Africa.

However, the findings of Second Chance Africa in Liberia indicate that one-on-one sessions are not the only way to help Liberians to escape the symptoms of complex trauma and PTSD and to rejoin their communities as fully functional and healthy members.

Rather, a well-crafted curriculum of group-based discussions, and group therapy has already helped thousands of the poorest and most-affected Liberians to experience lasting relief from their symptoms at a fraction of the price of interventions that require one-on-one approaches.

Our Community Mental Health Facilitator app project seeks to digitize and iterate Second Chance Africa’s approach into a free and open source app for community health workers to lead low-cost, easy to scale groups in their own languages and sociocultural contexts.

Quality mental health care used to be something only available for the rich, something health systems burdened by multiple and systemic challenges dismissed as impossible, with their limited resources and competing priorities. This is finally changing.

By working with community health workers connected to decentralized district health systems, psychosocial trauma support can be part of the package of basic health services available to all.

And here’s where things get really interesting.

Neither the World Bank nor USAID’s interventions leverage technologies to increase future scalability. As we see it, the approach pioneered by Second Chance Africa becomes even more cost-effective and impactful through the careful application of mobile and digital technologies.

As community health workers are increasingly equipped with mobile devices and trained to use them, trauma-focused community mental health support can spread to the farthest reaches of a country’s health system. With basic training and in-app support materials, we can build the capacity of community health workers to add PTSD-focused mental health interventions to their toolbox of community-based health services.

The potential of such an intervention for massive impact starts to become apparent when we consider the scope of the problem. In 2012, an estimated 172 million people were affected by conflict worldwide and an estimated 375 million were affected by climate disasters.

We have a humanitarian imperative to ease trauma with the best tools at the lowest cost. Using mobile technology—we can do this, and we can do it within the structure of existing health systems.

Image Credit:


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How Old Are You, Really? Biological Age Is Harder to Pin Down Than You Think

by System Administrator - Tuesday, 26 January 2016, 7:29 PM

How Old Are You, Really? Biological Age Is Harder to Pin Down Than You Think


In less than a month, I’ll be leaving my roaring 20s behind.

Like anyone crossing into a new decade of life, it feels surreal. I don’t look 30. I don’t feel 30. My health is better than it’s ever been. I tell my doctors I’m hitting the big 3-0 simply because that’s what the calendar — my only yardstick for the passage of time — is telling me.

But what if there’s a better measure for age? A number that reflects how well your body is functioning as a whole, that predicts how rapidly you’re aging, that informs physicians when to expect medical issues, that aids the search for anti-aging therapies?

That number is a person’s biological age.

Scientists are increasingly making the distinction between your chronological age — the number of years that you’ve lived — and your biological age.

It’s not just an academic curiosity. A 2015 study, which comprehensively analyzed the function of multiple body systems of nearly 1,000 young adults, found that a 38-year-old’s biological clock can read anywhere from a spritely 20 to a feeble 60.

Even more frightening is this: although none of the participants had overt health issues, some were aging three times faster than expected.

Most people think aging happens only later in life, but — not to be macabre — our life expectancy clocks are constantly ticking down, said first author Dan Belsky, a researcher at the Duke University Center for Aging.

If we want to prevent age-related disease, we’re going to have to start treatments young, he explained. The problem is: what is “young”? How do we tell a person’s true biological age?

It’s a surprisingly hard question to answer.

Belsky took the clinical route, repeatedly giving their participants the ultimate full body workup over multiple years.

His team measured the function of the liver, kidney, heart and immune system. They tracked metabolic rate, cholesterol levels, aerobic fitness and lung function. They measured memory, reasoning and creativity. They even looked at the length of telomeres — protective “caps” at the end of chromosomes that safeguard our DNA and chip away with age.

Using these data, the team was able to construct a monster algorithm that calculates a person’s biological age and predicts the pace of deterioration.

The study made waves, and for good reason: for the first time, scientists are able to quantify aging in a younger population before the first hint of diabetes, Alzheimer’s or other age-related diseases appears. Imagine if your biological age is 10 years older than what you expected, said Belsky. It’s like a tap on the shoulder, letting you know that you need to exercise, to try caloric restriction and take better care of yourself.

Yet Belsky stresses that his study is proof-of-concept only. It took years and a fortune, he laughed. For a test for biological age to go mainstream, we need “better, faster and cheaper” markers and methods.

The dream is to take a sample of your skin or blood and tell you what your biological age is, much like a saliva sample sent to 23andMe can tell you (among other things) what kind of earwax you have.

While researchers still disagree on what constitutes a good marker, recent advances have yielded a group of candidates.

All are related to molecular processes that correlate with aging.


Chromosomes are capped with repeating nucleotide sequences called telomeres that get shorter over time.

Backed by decades of research and a Nobel Prize, telomere length — a measure in Belsky’s study — is perhaps the leading candidate.

Discovered in the 1980s, telomeres are extra ATCG bits that trail off the end of chromosomes. Every time a cell divides, telomeres get chopped shorter, until they reach a critical length and prohibit the cell from dividing further. Subsequent population-wide studies found correlationsbetween telomere length, disease and mortality, further increasing its worth as a marker for biological age.

Scientists and investors alike have taken notice.

In 2010, Elizabeth Blackburn, one of the discoverers of telomeres, started a company in Menlo Park, California that provides analyses of telomere length from a person’s saliva sample. Life Length, a startup based in Madrid, claims to calculate a person’s biological age by the median length of their telomeres — if you’re willing to shell out $395 a pop.

Geron, another Silicon Valley company initially backed by Blackburn’s protégé, Carol Grieder, promised substantial clinical benefits of its telomere tests before abruptly switching gears. It now focuses on cancer therapies, and Grieder has long left her role as advisor to the company.

Geron’s switch away from telomere-based aging assays is telling. Telomere tests are fast, easy and cheap, but there’s one problem — they don’t particularly reflect age accurately when it comes to each individual person.

Honestly, the value of such tests is their “cocktail party” appeal, said Jerry Shay, a biologist at the Texas Southern Medical Center and advisor to Life Length. The variation in telomere length among people of the same age is huge, he explains. Besides, longer is not always better — recent studies have revealed a tradeoff between long telomeres and a higher risk of cancer.

Despite these caveats, telomere length still remains a highly valuable marker. “There’s going to be a huge amount of heterogeneity in any marker,” said Grieber. Telomeres are just part of the puzzle — the question is, what other markers can help complete the puzzle?

Eline Slagboom, a molecular epidemiologist at Leiden University in the Netherlands, has her money on blood.


Human red blood cells.

Blood provides oxygen vital nutrients to every tissue in our body and in turn receives their waste products. We’ve known for years that the levels of some types of waste go up with age and correlate with declining organ function, said Slagboom.

For example, a 2011 study from Tony Wyss-Coray and Saul Villeda, then at Stanford University, found that injecting a young mouse with blood collected from an aged mouse throttles its brain function. Subsequent studies also showed negative effects of old blood on the liver and heart of younger recipients.

There’s a wealth of information hidden in blood, said Slagboom. Her team is running a massive study of 3,500 people aged between 40 to 110, looking at molecules in the blood that associate with age-related diseases, including cardiovascular health, dementia, diabetes and depression.

Slagboom and others’ efforts have already led to several pro-aging candidates.

Surprisingly, many are linked to the body’s immune function, which goes into overdrive with age. One candidate, with the unwieldy name of alpha1-acid-glycoprotein, is known to increase with age and independently predicts a higher risk for mortality. Another, B2M (beta-2-microglobulin), floods the body in old age and disrupts learning and memory.

Without a doubt, the race for identifying pro-aging (and pro-youth) factors is heating up.

Earlier last year, Wyss-Coray snapped up $50 million to fund his startup Alkahest, which hopes to reverse brain deficits by inhibiting pro-aging factors that accumulate with age. Although focuses on developing blood-based therapies, it’s not hard to imagine that the slew of pro-youth and pro-aging factors it uncovers could be used to measure a person’s biological age.*

In the end, no single factor — telomere, alpha1-acid-glycoprotein, B2M or other harder to measure markers such as DNA and protein damage — can paint a complete picture of a person’s true age. It’ll take multiple factors and a lot of trial and error.

But the stakes are sky high; for startups in the game of measuring biological age, literally so.

Objective age-related markers could push the anti-aging field into a whole new era, said Luigi Fontana at Washington University. They give us a way to test promising anti-aging drugs such as rapamycin andmetformin using short-term clinical trials. Instead of decades, we could be looking at months.

I can’t stress this enough, said Fontana. Knowing someone’s biological age is “very, very important.”

* Disclosure: The author works as a postdoctoral researcher with Dr. Saul Villeda, an advisor to Alkahest, at UCSF to study pro-youth factors in young blood.

Image Credit: sergign/Shutterstock.comunderworld/Shutterstock.comAJC Commons

Shelly Fan

  • Shelly Xuelai Fan is a neuroscientist at the University of California, San Francisco, where she studies ways to make old brains young again. In addition to research, she's also an avid science writer with an insatiable obsession with biotech, AI and all things neuro. She spends her spare time kayaking, bike camping and getting lost in the woods.


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How One Hospital Turns Doctors into Leaders

by System Administrator - Wednesday, 24 December 2014, 5:26 PM

How One Hospital Turns Doctors into Leaders

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How Practices Can Compete With Walk-in Clinics

by System Administrator - Thursday, 8 January 2015, 2:40 PM

How Practices Can Compete With Walk-in Clinics

Consumers are accustomed to new medical practices emerging in their community from time to time and so are physicians. This is not unusual, but now we are seeing a new kind of medical practice popping up all over the place. They are at Wal-Mart, Walgreens, and even on the corner strip malls. These new competitors are walk-in clinics, known by a variety of names, like Minute Clinic, promising easy access and convenience that is not always available in the typical medical practice — whether you are a primary-care physician or a specialist. So how do you compete? 

First of all, don't assume you know more about these clinics than you actually do. Find out all you can about these clinics, and discover what you have to offer patients that they don't. You might even want to explore the possibility of collaborating with a local walk-in clinic, based on the unique services that your practice provides. For example, if its goal is to only see patients with an acute illness or injury, but not provide ongoing care, you might be able to secure referrals for patients needing follow-up care. If providers at the clinic treat a patient for a cough, but discover he has high blood pressure, could you become the cardiologist of choice? And if you don't treat patients for workers compensation injuries, perhaps there's an opportunity for cross referrals.

Many of these clinics are employing nurse practitioners or physician assistants. Meet these providers and talk about being available for consult, if they have questions when treating a patient that presents with unusual symptoms. Check out their qualifications, experience, and areas of expertise. If you feel confident in their capabilities, it might make sense to refer your patients to their clinic for urgent, after-hour care like an ankle sprain, a cough, or a fever — as long as patients know they should return to you for follow-up care. For patients that do not have serious symptoms, it can be more advantageous to visit a walk-in clinic than being seen in an emergency room that has higher costs and often longer wait times.

It's really all about better channels of communication and building a supportive clinical relationship that nurtures opportunities for collaborative patient care, improving patient compliance, and providing for continuity of care. Isn't that really what we all want? In the end, it may even contribute to managing medical expenses better without compromising clinical outcomes.


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How to Apologize for a Medical Error

by System Administrator - Friday, 27 February 2015, 12:54 PM

How to Apologize for a Medical Error


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How to Deal with an Annoying Medical Practice Coworker

by System Administrator - Thursday, 8 January 2015, 2:48 PM

How to Deal with an Annoying Medical Practice Coworker

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How to Leverage a Big Data Model in the Network Monitoring Domain

by System Administrator - Tuesday, 7 October 2014, 9:05 PM


How to Leverage a Big Data Model in the Network Monitoring Domain

Network monitoring is on the cusp of a radical shift away from the prevailing paradigm of appliance-only deployments. Because of this rapidly changing architecture, IT teams need to keep pace with the changes to give their users and employees as much visibility as possible. Download this whitepaper to learn how to leverage a big data model in the network monitoring domain and see why IT is shifting away and how your team should react to keep up.

Please read the attached whitepaper.

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How to Train Thousands of Surgeons at the Same Time in Virtual Reality

by System Administrator - Sunday, 16 October 2016, 11:05 PM

How to Train Thousands of Surgeons at the Same Time in Virtual Reality


Recently, I wrote about how the future of surgery is going to be robotic, data-driven and artificially intelligent.

Although it’s approaching fast, that future is still in the works. In the meantime, there is a real need to train surgeons in a more scalable way, according to Dr. Shafi Ahmed, a surgeon at the Royal London and St. Bartholomew's hospitals and cofounder of Medical Realities, a company developing a new virtual reality platform for surgical training.


An operating theater.

Hundreds of years ago, training happened in an “operating theater,” where many would-be surgeons peered over each other’s shoulders to try to get a glimpse of the action and learn as best they could. The reality is, this method of training still hasn’t changed much to this day.

At the same time, two thirds of the global population still doesn’t have access to safe and affordable surgery.

According to the Lancet commission on global surgery, the surgical workforce would have to double to meet the needs of basic surgical care for the developing world by 2030.

Dr. Ahmed is working to solve this problem. He imagines being able to train thousands of surgeons simultaneously in virtual reality.

Speaking at this year’s Exponential Medicine conference, Ahmed painted a vivid picture of the need for a scalable surgical education.

“Imagine that you're a surgical trainee in Tanzania. You're restrained by geography, you're in a rural setting, but you want some training. You want to improve the standards of your health care system, as every doctor does… Imagine you're a surgeon, maybe an attending in Bangladesh, a population of 150 million with a very poor infrastructure of training and teaching….Imagine you're a school kid in a inner city area, a poor district. But then you want to be a surgeon, you want to train to be a medic, you want to access information. You'd like to know what it's like and immerse yourself.”

Ahmed believes that education is a basic, fundamental right for everyone and that with virtual reality, he can train surgeons across the world in a way that has not been possible before today. 

Dr. Ahmed has already made some steps towards this reality. In May of 2014, he streamed a training session through Google Glass, reaching 14,000 surgeons across the world.  

In April of 2016, he live-streamed a cancer surgery in virtual reality. The procedure, a low-risk removal of a colon tumor in a man in his 70s, was filmed in 360 video and streamed live across the world. The high-def 4K camera captured the doctors’ every movement, and those watching could see everything that was happening in immersive detail.

[Note: This video shows a live surgery. Content may be too graphic for some viewers]

Surgical Training in 360-Degree Virtual Reality for Oculus Rift (with intro + narration)

This is a 360 degree video, click and drag to change the angle of view.
Watch using Chrome browser on desktop or the YouTube app on Android devices to view in 360 degrees.
Click 'SHOW MORE' below for more information.

So today, we already have the technology to allow medical students to stand in the shoes of an experienced surgeon. What’s next for surgical education?

“In time, we [will be] wearing gloves or body suits [so] we can touch and feel things in the virtual world. Then ultimately, imagine being a virtual surgeon, where you pop into a virtual theater [with] virtual patient [and] virtual instruments and do a virtual operation,” says Ahmed.

First Oculus Rift Surgery

This video is a teaser of a project funded by the MOVEO Foundation aiming to improve surgeon training.

Want to keep up with coverage from Exponential Medicine? Get the latest insights here.

Image credit: Shutterstock


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How wearable cameras can help those with Alzheimer's

by System Administrator - Monday, 11 August 2014, 2:57 PM

How wearable cameras can help those with Alzheimer's

The wearable camera is being touted as the latest must-have accessory for social-media obsessives, but is a real boon for helping people with serious medical conditions recall important events in their lives.
The Microsoft Research SenseCam has spawned a new generation of technology aimed at tech-savvy twentysomethings.
Some people hang out with their friends on yachts or play pool with pretty girls. Others like to go on treetop zip-wire adventures and holiday on wooded Thai islands. These examples of images on the websites ofAutographer and Narrative Clip, two leading wearable cameras, reveal the kind of things their makers imagine we might do with their devices.
These gadgets automatically snap hundreds of photos per day from their user's perspective. The much-awaited Google Glass, expected to go on general sale within months, will be able to do the same thing. Some believe future historians will peg 2014 as the dawn of the "life-logging" era, in which many or even most of us will carry devices that record images or video of our daily lives.

Beyond the huge privacy implications, the big question is: can this technology improve our lives? For the current market leaders, it is about providing tech-savvy twenty- and thirtysomethings with a way to generate automatically digital photo albums of unprecedented detail and supercharging their social media-sharing capabilities. Some "self-quantifiers" are already using continuous image-gathering as part of personal improvement projects such as losing weight or boosting their productivity.

But such applications are far removed from those envisaged by the technology's early developers, who set out to create visual aids for people with failing memories. And those pioneers may yet be vindicated. Early research suggests that these devices can not only help those with amnesia and dementia recall important events, but may also be able to improve their memory abilities.

One of those innovators was Lyndsay Williams, who probably has the best claim to have been the first to come up with a device capable of taking large numbers of still images automatically. In 1999, shortly after having joined Microsoft Research Cambridge, she attached a digital camera linked to an accelerometer to her bicycle's basket. Her "SenseCam" was designed to take pictures when she was forced to brake hard, in order to capture the details of careless drivers. Williams had temporarily lost six months of memories as a result of being the victim of a hit-and-run road accident aged 17, and she hoped her invention could help others in the same boat. "After that bang on the head I couldn't remember whether I'd been to a concert I had a ticket for or whether I'd done my exams, so I was keenly aware of the frustration of memory difficulties," says Williams, now an independent design consultant. "I also wanted to help a friend who was always losing their keys and their spectacles."

In March 2004, Microsoft filed a patent application for a "recall device" that could help "a victim of Alzheimer's disease and his/her care-giver to reconstruct a portion of the individual's daily activity". Researchers at Addenbrooke's hospital's memory clinic began a collaboration with nearby Microsoft Research in Cambridge to investigate the technology's potential for its patients.

In a case study published in 2007, they revealed that a 63-year-old librarian known as Mrs B, who had amnesia caused by a brain infection, could recall more than 80% of key facts about significant events after a fortnight of reviewing SenseCam images every couple of days and that a similar level of recall persisted for months after she stopped looking at the pictures. This compared with being able to recall just under half of the details using a written diary and no recall at all without either intervention after five days.

Two years later, they published a study in which Mrs B showed increased activity in the parts of the brain linked to experiences associated with time and place, known as episodic memories. They concluded that the device could provide cues that help bring back stored but inaccessible memories, including thoughts, feelings and occurrences not in the images themselves.


Amnesia sufferer Jonathan Eason.

This finding was reinforced by work with Jonathan Eason, a politics student who suffered amnesia, anxiety and depression after being assaulted by two strangers. In the same year, the Addenbrooke's-Microsoft Research group reported that a Mrs W, who had memory problems, was able to recall twice as much detail about events six months old when she viewed streams of SenseCam images over two weeks compared with discussing a written diary for the same amount of time.

The first study involving a number of Alzheimer's patients was published earlier this year by an Addenbrooke's team led by neuropsychologist Dr Emma Woodberry. Six patients with mild to moderate Alzheimer's were able to recall an average of 85% of key factual details about events after a fortnight of viewing SenseCam images every other day. When this was replaced by discussion of a written diary, this fell to 56% and with no intervention it was 33%. Three months later, without any image-viewing, they could still recall an average of just under half of key details, more than three times better than when using a diary.

"Sharing experiences with loved ones is really important to our sense of wellbeing, identity and closeness with the people we love," says Woodberry. "Losing that is debilitating and has a profound effect on your relationships. It's too early to say whether it can slow progression of Alzheimer's, but I think it can improve quality of life in the here and now."

Dr Doug Brown of the Alzheimer's Society believes larger studies are needed. "These findings are interesting but the study is too small to draw any firm conclusions about whether this particular technology is something that we should make widely available to people with dementia, but it's an area that warrants further investigation." His wish could soon be granted: two larger trials are being conducted in France and Portugal.

Others are not only more bullish about the technology's ability to help patients cope day to day, but believe it can have more profound, longer-term effects. A decade ago, Claire, a nurse who lives in Cambridgeshire, awoke from a coma brought on by viral encephalitis, an infection that affects the brain. Then aged 43, she no longer recognised the five people around her bedside as her husband, Ed, and their four children and remembered nothing except some vague childhood memories.

She began using a SenseCam several years ago as part of research led by Dr Catherine Loveday, a cognitive psychologist at the University of Westminster. She uses it most days and views sequences of the images to help her in various situations, such as when she is about to meet a friend. "It can be the oddest little thing in the corner of a picture or somebody's expression that triggers a memory," she says.

"In my friendships, I often feel inadequate because the other person knows about me and the parts of our lives we've shared and I can't remember a single thing about them, their families, or things they might have told me about yesterday. Looking over the images gives me a feeling that I can feel part of our friendship and a tremendous sense of security." Claire is now able to retain recent memories of events as a result of repeated viewings of SenseCam images of them.


'Sometimes, an inventor comes up with the perfect solution but the world isn’t quite ready for it.' Photograph: Katherine Rose for the Observer

Loveday believes pictures from the device help cue recall because they are similar to the snapshots of moments we store and stitch together into narratives to form our natural autobiographical memories. "We think viewing the images in sequence triggers activity in the same brain circuits that were triggered when you first experienced the events and that by doing so repeatedly you can prod the memory into consciousness. I think anyone who has a problem with memory could get a good degree of day-to-day support from using this technology, and, although the evidence is too limited to say for sure at the moment, I think that for some people there is also the possibility that it could lead to recovery of some function."

These encouraging early findings led UK company Vicon Motion to license the technology from Microsoft and launch it in 2010 as the Vicon Revue, a £500 device aimed mainly at people needing memory aids. However, sales were disappointing and it stopped selling the device in 2012. The newer Autographer, marketed more as a visual diary gathering tool, is also based on SenseCam, using sensors to identify action and trigger picture-taking.

Steve Hodges, who leads Microsoft Research Cambridge's sensors and devices group, believes it won't be long before the use of wearable cameras by those with memory loss becomes commonplace.

"Sometimes, an inventor comes up with the perfect solution but the world isn't quite ready for it," he says. "This technology has great deal of potential for those with memory problems and as the devices become more acceptable and commonplace, and they get cheaper and storage and access technologies become more mature, I think we'll see larger trials and more patients using it."

A sufferer's story

Their vows were exchanged beneath a potted maple. The bride wore white and the groom a silver waistcoat and a teal tie. Happy by Pharrell Williams was playing as they left the church.

Jonathan Eason suffers from a form of amnesia that means that even though he was the groom in question, these details of his wedding day at St Ives methodist church, Cambridgeshire in May would all have been lost to him within 24 hours without employing techniques to retain important memories. His use of SenseCam has taught him how to recall things by repeatedly viewing images of them.

"I've lost so many memories and forgetting my wedding day was one of my greatest fears," he says. "It's such a special memory and knowing that it is one I can keep, talk about and share with other people makes me very happy."

Eason, 33, suffered severe head injuries in an unprovoked attack by two strangers while celebrating his 21st birthday in Cambridge. He was about to start his third year studying politics at Queen Mary University of London. The assault left him suffering significant memory impairment, attention problems and anxiety. A subsequent car crash made matters worse, causing low self-esteem, panic attacks, depression and agoraphobia.

Eason first used SenseCam in 2006 as part of a course of treatment devised by experts at the Oliver Zangwell Centre for Neuropsychological Rehabilitation in Ely, Cambridgeshire. Now he uses it alongside note-taking when doing things he wants to remember, such as going on holiday – or getting married. He did not wear the camera during his wedding, but his previous experience of using it taught him how repeatedly viewing the pictures others took would help him retain the memories. He still needs to be accompanied when he goes out, but the device has helped him overcome his social anxiety to the extent that he was able to get married in front of 100 guests, something he wouldn't previously have been able to do.

"Having memory problems can make you inhibited, preventing you from doing new things or even just things that other people consider routine," he says. "But being able to view a record of myself doing things successfully acts as a reminder and has given me more confidence. It has allowed me not only to keep hold of precious memories but also to do normal things like going shopping."


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How Your Hospital Can Overcome the Nursing Shortage and Maximize Profits

by System Administrator - Tuesday, 16 September 2014, 8:46 PM


How Your Hospital Can Overcome the Nursing Shortage and Maximize Profits

Adam Groff Hospitals
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Hybrid Cloud Powers Next Generation Health IT

by System Administrator - Monday, 10 November 2014, 2:30 PM

Hybrid Cloud Powers Next Generation Health IT

The shift from fee-for-service to value-based care is creating significant financial and performance pressures for healthcare providers. As Health IT leaders work to harness cloud, Big Data, mobile, and social technology to optimize their EMR, building a trusted hybrid cloud infrastructure lays the foundation for team-based care.

In this whitepaper, learn how a hybrid cloud framework enables coordinated care to improve patient care delivery, lower IT costs, and increase business agility – including recommended steps and solutions.”

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Gain the ability to stretch your IT budget – as you shift capital expenses to operating expenses.

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