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Tablet-based Telehealth Service

by System Administrator - Thursday, 23 October 2014, 8:02 PM
 

Panasonic Launches Tablet-based Telehealth Service for Seniors

Panasonic Corporation announced it will launch a tablet-based telehealth service in November called On4Today, a non-clinical telehealth service provided to long-term care and assisted living facilities. Designed as an ‘always on’ service, On4Today bridges potential communication gaps between assisted living facility residents and their families, friends and care providers. It delivers connectivity and easy-to-use communications intended to improve staff efficiencies, reduce anxiety for residents, promote peace of mind among family and friends and encourage stronger levels of resident engagement.

The new Health and Wellness Solutions business group is part of Panasonic’s ongoing business transformation and will deliver technology solutions to the healthcare market.

With the launch of On4TodayTM, Panasonic is demonstrating the types of solutions and new generation of networked health information technologies that are enabling providers to deliver cost-effective services. Health and Wellness Solutions will leverage Panasonic’s engineering roots and technology portfolio to address the challenges associated with individual and population health management. 

How It Works

 

On4TodayTM is delivered on a tablet and the tablet connects through WiFi. The lightweight device is portable and gives residents options to manage daily activities with calendar appointments and reminders, view photos and videos, and participate in video chats and messaging. Large font size, audio and visual prompts and touch screen scrolling features simplify site navigation and message access. The service is intuitive and can be customized, depending on long care or assisted living facility needs or individual preferences. 

“Quality and reliability are essential attributes for any long-term care or assisted living facility,”said Bob Dobbins, Vice President, New Business Development, who leads Panasonic’s new Health and Wellness Solutions group. “Panasonic’s health and wellness solutions reinforce the importance of those characteristics by bringing advanced technology into the care continuum to create more meaningful interactions, generate higher levels of resident well-being and reduce facility costs.”

Link: http://hitconsultant.net

 

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Technology drives patient power in Norway

by System Administrator - Monday, 21 September 2015, 12:30 PM
 

 

Technology drives patient power in Norway

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telecomunicaciones al servicio de la salud

by System Administrator - Friday, 31 March 2017, 12:24 PM
 

 

Las telecomunicaciones al servicio de la salud

Las telecomunicaciones y las tecnologías de la información y las comunicaciones (TIC) han experimentado grandes avances en las décadas recientes y hoy ocupan un rol importante en la vida de las personas. En el cuidado de la salud, por ejemplo, estas tecnologías tienen mucho que ofrecer.

En los últimos años, es cada vez más frecuente oír acerca de conceptos como tele salud, eSalud, telemedicina y mSalud, entre otros. Desde la perspectiva de organismos internacionales como la Organización Mundial de la Salud, estos conceptos se refieren al uso en forma eficiente, económica y segura de las TIC para brindar apoyo la salud y los ámbitos relacionados con ella.

Entre estos conceptos, la tele salud es considerada una de las principales innovaciones en los servicios sanitarios, no sólo desde el punto de vista tecnológico sino también cultural y social, ya que permite mejorar el acceso al cuidado de la salud, así como también la calidad de los servicios y la eficiencia organizacional, especialmente cuando las distancias son un factor crítico.

 

Entre otros usos, la tele salud puede ser empleada para que los profesionales de la salud intercambien información de diagnóstico, tratamiento y prevención de enfermedades —por ejemplo, para realización de interconsultas—, así como también para la capacitación de profesionales en centros de atención remoto de zonas rurales o alejadas de los grandes centros urbanos, entre otros.

En este aspecto, las telecomunicaciones inalámbricas y móviles poseen un gran potencial a ser desarrollado en beneficio de este tipo de iniciativas. Por sus características técnicas, y dado que el despliegue de este tipo de redes es más rápido y económico que la infraestructura cableada, es una excelente alternativa para brindar accesos para complementar la atención médica en áreas remotas o de población dispersa.

Asimismo, la masificación y amplia adopción de los teléfonos móviles inteligentes los convierte en dispositivos ideales tanto para el intercambio de información como para el uso de aplicaciones y servicios relacionados con la salud.

Link: http://www.itsitio.com

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Telehealth Adoption

by System Administrator - Thursday, 14 August 2014, 8:47 PM
 

Why telehealth adoption requires more than policy changes

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Telehealth Visits with Doctors

by System Administrator - Saturday, 18 October 2014, 9:53 PM
 

Google Offers Telehealth Visits with Doctors When You Search for Symptoms

According to the Pew Research Center, 59% of U.S. adults say they use the Internet to research and gather health information. Approximately 35% of those adults end up using the information they find to diagnose themselves. To solve this problem growing trend of self-diagnosers, Google is reportedly testing aHelpouts- style feature that offers video chats with doctors when consumers search for symptoms/conditions online, Endgaget first reports.

The feature was first revealed when one Reddit user searched for “knee pain” on his Android device and was offered to “talk with a doctor now.” Google confirmed Saturday with Engadget that it was indeed testing the new feature with a limited number of users when they search for medical advice. For now, it is only a limited trial period and Google will incur all costs incurred during the trail. In an official statement to Gizmodo on Sunday, Google stated:

“When you’re searching for basic health information — from conditions like insomnia or food poisoning — our goal is provide you with the most helpful information available. We’re trying this new feature to see if it’s useful to people.”

Google Helpouts is a HIPAA-compliant, secure, pay-per-use version of Google Hangouts and already has several physician practices offering free and paid consultations.  If Google does decide to enter the telehealth space, it could be a game changer for the telehealth industry. Telehealth startups such as Teledoc, Doctor on Demand, and VSee could face serious challenges competing against the reach of Google.

Link: http://hitconsultant.net

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Telemedicina como mejora de la resolución local

by System Administrator - Friday, 5 September 2014, 10:26 PM
 

“El sistema de telemedicina que estamos desarrollando busca mejorar la capacidad de resolución local”

El Dr. Joaquín Héctor Gonzalez está a cargo del Departamento de Comunicación a Distancia del Hospital Garrahan y en esta entrevista repasa cuándo se inició, en qué consiste y cómo funciona el programa interprovincial de telesalud.

Por Nicolás Parada

El Hospital de Pediatría Prof. Dr. Juan Pedro Garrahan, de Argentina, es un nosocomio público de alta complejidad que desarrolla desde 1997 el primer programa de telemedicina del país. 

El proyecto, llamado Referencia-Contrarrefencia, promueve polos de salud a nivel provincial y regional, y busca alentar el acceso igualitario a consultas con médicos especializados.

El pediatra Joaquín Héctor Gonzalez es el responsable del departamento de Comunicación a Distancia y, desde hace 25 años, se desempeña como médico de la oficina de comunicaciones del hospital. En esta entrevista repasa cuándo se inició, en qué consiste y cómo funciona el programa interprovincial.

¿Cómo surgió la idea de implementar telemedicina en el Hospital Garrahan?

El programa empezó en el Hospital de Día en 1997; la mejora del servicio de internet en el país permitió el trabajo punto a punto con los hospitales. Desde su implementación se recibieron unas 50 mil consultas y el 80% de los pacientes no tuvieron necesidad de trasladarse hasta el hospital, ubicado en la Ciudad Autónoma de Buenos Aires.

¿Qué motivos impulsaron el proyecto?

Varios: teníamos chicos que venían desde lejos por una enfermedad que se agravaba durante el viaje; recibíamos a niños que se acercaban sin información clínica y, una vez terminado el tratamiento, no teníamos a quién transferirlo porque no sabíamos quién era su médico de cabecera; atendíamos a pacientes que podían ser atendidos perfectamente en su zona de residencia; y la lista sigue…

¿Cómo es el sistema de gestión de turnos?

Se dan turnos programados, esto permite que un paciente del interior que llega a la mañana sea internado en un horario determinado para hacer los estudios y las consultas necesarias.  A las 8 horas ya se tiene un resumen de la revisación o alguna conclusión, tratamos de hacer todo en 24/48hs. De hecho, los turnos se programan considerando que el paciente quedará dos días en el hospital. 

A su vez, luego de programar el turno, nos comunicamos con el lugar donde el niño es atendido habitualmente y, a través del servicio social, se genera la derivación considerando que va  a estar en Buenos Aires por lo menos un día.  Entonces fijamos, así, dónde va a pasar la noche, puede ser en Casa Garrahan o en un alojamiento externo.

Los hospitales con los que trabajan, ¿son sólo públicos?

Se complica el asunto del manejo de lo público y lo privado. Por ahora, nos manejamos sólo con hospitales públicos porque no generamos actividades con lucro, aunque cada tanto hacemos alguna excepción. 

Nosotros disponemos del equipamiento como para no necesitar ninguna contraprestación al hospital privado, pero ellos, en cambio, generan un lucro facturando el servicio que nosotros le ofrecemos sin costo.

De todos modos, en la provincia están viendo de generar convenios con hospitales del ámbito privado; sobre todo con los que tienen seguros de salud en la provincia, que se consideran como públicos pero en los hechos no lo son. 

¿Qué planes se están desarrollando a nivel nacional?

Hay un subsidio del Banco Interamericano de Desarrollo (BID), a través del Ministerio de Ciencia y Técnica, para equipar a 140 hospitales con aparatos de videoconferencia, una red de telefonía IP y un sitio web. 

Todos los equipos, destinados a los hospitales de referencia y a los 23 Ministerios de Salud, van a ser utilizados para docencia e interconsulta. Además, se añadió un nuevo proyecto, al que se sumó el Ministerio de Planificación a través del Ministerio de Ciencia y Técnica por medio de un convenio con el Ministerio de Salud, que incorporará equipos de videoconferencia a otros hospitales y generará una red de atención a embarazadas y adultos. 

Esta red se generaría, en un 90% de los casos, en las mismas instituciones de salud con las que trabajamos, porque la mayoría no son exclusivamente de niños: nosotros trabajamos en la red privilegiando lo pediátrico, que es lo que sabemos hacer, pero se está pensando aprovechar las mismas oficinas, la infraestructura que se tiene, los vínculos de contacto que se están haciendo a través de la red pediátrica, para generar una red de adultos y de maternidad.

¿Cómo es el trabajo con las provincias?

El sistema que usábamos hasta 2001/2002 con los hospitales de las otras provincias generaba un quiebre en el sistema de referencia local. Por ejemplo, tenemos el caso de Neuquén: nos dimos cuenta de que trabajábamos con el hospital de Zapala, que es de mediana complejidad, y los médicos, en lugar de consultar al hospital central de la provincia, nos consultaban a nosotros. Se terminaban generando derivaciones de pacientes que no cumplían el recorrido que tenían que hacer dentro de la provincia para volver el sistema más eficiente; es decir, se venían a Buenos Aires por algo que bien se podía resolver allá.

Entonces cambiamos el objetivo y decidimos armar una red de hospitales de referencia en pediatría en cada provincia; y, a su vez, que cada provincia generara su red interna.

En Neuquén hay un solo polo central, pero, por ejemplo, en Río Negro hay cuatro unidades de la misma complejidad: Bariloche, General Roca, Cipolletti y Viedma. La provincia no tiene un solo polo central donde van todos, sino que distribuye la salud pública en cuatro polos. Nosotros respetamos esa referencia local, tratamos que interactúen entre ellos y trabajamos asumiendo que tienen cuatro polos de desarrollo, privilegiamos que la red sea armada por la provincia.

¿Y en las provincias cómo se está desarrollando las redes locales?

Todavía falta armar vínculos regionales entre las provincias. El sistema de telemedicina que estamos desarrollando busca mejorar la capacidad de resolución local.

En mi opinión, la telemedicina se divide en dos sistemas:

1. Tipo red sanitaria: va un ómnibus del Garrahan a una provincia con especialistas y equipamiento, atienden a los pacientes, se va el ómnibus, y no queda nada.

2. Programa Rederencia-Contrarreferencia, que es el que venimos desarrollando. Se trata de una estrategia de colaboración; mediante herramientas del sistema de comunicación a distancia, se generan vínculos que permiten la formación de especialistas a nivel local. Por ejemplo, se detecta que en una provincia no hay neurólogos y tienen una persona que quiere trabajar como neurólogo en el hospital. Supongamos que ya haya hecho la residencia y que tiene la edad adecuada para formarse, hay un examen al que puede aplicar para entrar como becario en el Garrahan y hacer la formación como especialista. 

¿El Garrahan atiende a toda persona que se presente en el hospital o deriva en casos de no requerir alta complejidad? 

Vienen muchos pacientes con patologías respiratorias que no serían alta complejidad sino patología estacional, y hay un montón de hospitales con capacidad de resolverlo. De todos modos, si alguien se presenta en el hospital es atendido. Los casos que no son demasiado complejos, que no requieren terapia intensiva, reciben un tratamiento operativo.

¿Este proceso no conduce a una saturación del sistema de salud del Hospital?

Esto es un hospital planificado para tener alta complejidad, pero también es abierto: pueden venir a atenderse cualquiera de cualquier lado. Cuando un paciente llega, tiene a su disposición un médico orientador. Lo que se trata es que lleguen los pacientes que haga falta atender acá, que no se puedan atender en otro lado.

¿Qué rol juega la Historia Clínica Electrónica (HCE) en el programa de telesalud?

La HCE está implementada en muy pocos países, hay  varios proyectos en pleno proceso de debate, pero todavía ninguno está aplicado. Hasta ahora el sistema es a través del fax, que era lo que había cuando empezamos. Le agregamos un mail para poder recibir las imágenes que antes mandábamos por correo. 

¿Cuál es su perspectiva a nivel nacional y continental sobre la telesalud?

Estamos con perspectivas de progreso. Nuestro programa se inserta en la colaboración con Ministerio, y la posibilidad del tendido de la red de fibra óptica que está desarrollando el plan Argentina Conectada es muy prometedora.

Podríamos aprovechar esa red para darle conectividad a las videoconferencias y generaríamos una plataforma bastante importante para vincular a todos los hospitales en red.

Brasil, por ejemplo, tiene una red de telemedicina bastante importante. A partir de lo que nosotros vimos, tienen un programa centrado en el centro universitario para consulta de médicos generalistas que atienden a grupos en zonas rurales. Lo que no realizan, en comparación con nuestro programa, es manejar la información de ida y vuelta. 

Consultan al centro universitario por un paciente, le ofrecen una devolución  sobre el procedimiento a realizar o si requiere internación,  y luego el médico generalista que está en la zona rural debe averiguar adónde derivarlo. La videoconferencia sirve como consulta en línea de lo que hay que hacer y el médico tiene que proseguir con lo que requiera el paciente, no tienen integrada la respuesta con una implementación programada de qué hacer.

Por otro lado, la Organización Panamericana de la Salud (OPS) está trabajando con un programa, como una clínica virtual, que falló porque tenía problemas de conectividad. Se intentó empezar un programa piloto en Jujuy que quedó demorado por problemas de conectividad. En la agenda de la OPS está presente el tema de la salud en red, es decir, la red como un concepto de redes integradas al servicio de salud.

Link: http://www.ehealthreporter.com

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Telemedicine market to nearly double over next 5 years

by System Administrator - Monday, 22 December 2014, 9:25 PM
 

Telemedicine market to nearly double over next 5 years

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Telesiquiatría

by System Administrator - Sunday, 28 September 2014, 1:25 PM
 

CONGRESO MUNDIAL DE PSIQUIATRÍA

La telesiquiatría, alternativa para atender la salud mental en las zonas rurales

MADRID 18 SEP, 2014

El Congreso Mundial de Psiquiatría, que se celebra esta semana en Madrid, ha acogido una mesa redonda en la que se ha puesto de manifiesto la eficacia de la telesiquiatría en las zonas más remotas del planeta; la mesa ha estado dirigida por Scott Zeller, psiquiatra de California (EE. UU.), y ha contado con Avrim Fishkind (EE. UU.), Eduardo Borbon (EE. UU.), Dywayne Bennet (de Reino Unido), Ian Dawe (Canadá), y Jennifer Chipps (Sudáfrica).

Todos ellos coincidieron en que la telepsiquiatría es un sistema “muy accesible que puede estar disponible en cualquier momento y en diferentes entornos clínicos y otros contextos” y afirmaron que “puede servir también como coadyuvante de los tratamientos que el psiquiatra administra, liberando tiempo clínico y ahorro de costes o proporcionando un tratamiento más específico adaptado a las necesidades del usuario”.

Avirm Fishkind dirigió el grupo de trabajo clínico para el rediseño de los servicios de manejo de crisis del estado de Texas y construyó un nuevo sistema de emergencia psiquiátrica en dicho territorio basado en la telepsiquiatría. Precisamente, es una de las ventajas de la telepsiquiatria, ya que permite dar una respuesta in situ en donde se produce un requerimiento de asistencia psiquiátrica (Ej. Centros penitenciarios).

Aunque la telepsiquiatría está ganando impulso y el apoyo de la comunidad psiquiátrica, su implantación en las redes asistenciales es todavía bajo. Este tipo de técnicas, entre otras ventajas, permite a los pacientes estar más tiempo con el experto en salud mental, señalaron los participantes en la mesa.

Estos servicios han de estar acompañados, agregaron, por un equipo de enfermeras y técnicos de la salud mental para una asistencia integral. Por su parte, el grupo médico que realiza las videoconferencias es entrenado para saber cómo tiene que mirar a la pantalla y la forma correcta para dirigirse a los pacientes. La terapia con los pacientes puede ser proporcionada por otros profesionales de la salud (médico de familia, psicólogo) y utilizar métodos no tradicionales como internet o la telefonía móvil. En el caso de la depresión, las intervenciones de baja intensidad se ofrecen a aquellos pacientes que presentan sintomatología depresiva leve o moderada.

Por último, los expertos indicaron que las nuevas tecnologías de la comunicación “ayudan a acercar a los pacientes a la psiquiatría”. Sin embargo, hicieron hincapié en que “su uso no ha de sustituir las terapias tradicionales y la telepsiquiatría no sirve para tratamientos psiquiátricos complejos en los que es necesario el contacto paciente-profesional”. “Aunque es un campo prometedor, también es cierto que muchos pacientes no siguen o rechazan la telepsiquiatría. Por ello, es necesario aún investigar mucho más y conocer qué perfil de pacientes podría beneficiarse de este tipo de psicoterapia y qué pacientes la rechazarían”, concluyeron.

Link: http://www.actasanitaria.com

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Ten Things Physicians Wish Patients Understood

by System Administrator - Tuesday, 20 January 2015, 9:36 PM
 

Ten Things Physicians Wish Patients Understood

By Aubrey Westgate

 

 

Tags:

  • Patient Relations,
  • Great American Physician Survey,
  • Healthcare Careers,
  • Patients

Please read the attached PDF

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Text Analytics in Healthcare

by System Administrator - Tuesday, 18 April 2017, 1:19 PM
 

Text Analytics in Healthcare—Two Promising Frameworks that Meet Its Unique Demands

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Text Messaging for Patient Acquisition: Expanding Your Healthcare Outreach Strategy

by System Administrator - Wednesday, 23 September 2015, 2:32 PM
 

Text Messaging for Patient Acquisition: Expanding Your Healthcare Outreach Strategy

Download our eBook to learn how you can use text messaging to reach more potential patients

Text messaging is increasingly being utilized as a mobile health tool to help patients achieve better outcomes. However, what most healthcare organizations don’t realize is text messaging’s ability to acquire new patients as an outreach and communication tool. With text messaging, your organization can start a conversation with potential patients and send targeted information directly to their mobile phones.

In our new eBook, Text Messaging for Patient Acquisition: Expanding Your Healthcare Outreach Strategy, we present how healthcare organizations can add text messaging to their marketing mix to reach and acquire more patients.

Read our eBook to learn:

  • The value of text messaging as an acquisition and communication tool in healthcare
  • How to promote a text messaging program across various outreach channels
  • Tactics for acquiring more patients with SMS for hospitals and healthcare providers

Por favor lea el eBook adjunto.

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The Best Thing I've Done for My Staff

by System Administrator - Saturday, 16 May 2015, 2:24 PM
 

The Best Thing I've Done for My Staff

We asked physicians to share their favorite tactics for rewarding and appreciating their staff members. Here's what they said.

Please read the attached slides.

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The consumerization of healthcare

by System Administrator - Thursday, 20 July 2017, 8:24 PM
 

Former Amazon exec discusses the consumerization of healthcare

by Kristen Lee

The consumerization of healthcare has gotten some buzz lately and now a former Amazon exec has entered the healthcare arena. He discusses ways to achieve consumerization.

A former Amazon executive, Tisson Mathew, led a team that built and operated Amazon's logistics technology platform that powers Amazon Prime Now, Amazon Fresh and Amazon Flex. Now, Mathew is bringing lessons learned from Amazon to healthcare as CTO of Alignment Healthcare, a Medicare Advantage health plan and provider based in Orange, Calif.

Mathew discusses these lessons and the value he believes they will bring to healthcare -- mainly, the consumerization of healthcare.

What are the lessons learned from Amazon that you think will bring value to the healthcare space?

Tisson Mathew: Amazon's biggest value is its culture of customer obsession. They obsess over customers' trust and keeping customers' trust. In healthcare the system is so not customer oriented, it's everything about the system and the process and we forget the consumer. I think the lesson I learned from Amazon is to work obsessively for the customer and work backward from them and then those solutions ... and building software and technologies that meet their needs is number one.

How do you see the consumerization of healthcare manifesting itself in terms of the technologies used?

Mathew: It all starts with transparency. Providing transparency to information, to the customer; it starts with that. And the second part of it is selection and choice for them and ultimately the outcome, the health outcomes... so in terms of transparency, information gathering is very critical for providing transparency. Cost, location and things like that that consumers are so used to now, push button, on demand, transparent information about product type or location of the service and getting access to them when they want it. And also selection, choice -- from a variety of merchants and providers in the healthcare space. And lastly is how they can realize value from it in the healthcare space is the outcome. So I think a lot of the technology aspects in terms of data analyticsand IoT or devices -- phones and monitoring devices -- are all playing a great part in providing information in such a way that customers can get that level of transparency and selection and choice and then be in control of their own health outcomes.

"Amazon's biggest value is its culture of customer obsession. They obsess over customers' trust and keeping customers' trust. In healthcare the system is so not customer oriented, it's everything about the system and the process and we forget the consumer."

Tisson MathewCTO, Alignment Healthcare

How and where is healthcare lacking when it comes to technologies that lead to the consumerization of healthcare?

Mathew: I think the number one problem is transparency. People don't know what they're paying for ... and what they get out of it. It's just a black box and so consumers struggle [with] making decisions and choices or their caregivers struggle. They don't know what doctor they go to, should go to ... so when in a consumerized world ... you have information transparency. So I think that is the number one struggle our industry is facing. But there has been progress, there has been progress in such a way that the technology is helping with transparency. So then the second part of it is outcomes. That is another area where technology is making improvements in specialized medicine, genomics and other areas.

In your opinion, what way would be most successful in delivering this information to patients?

Mathew: We have the best clinical care in this country but if we can marry that with digital information and cost selection to consumers that would drive down cost. So driving cost down and getting better value from all the different resources so that in turn requires transformation. For example, I can get into a car, an Uber and I get an estimate of the price. I can get in a taxi, I have no idea how much it's going to cost. ... So you know where you're going, it's on demand, you know what you're going to pay for, and it's available to you and you can make choices of your own.

What role does mobile play here?

Mathew: These devices are getting incredibly smarter about knowing us as human beings, especially the machine learning getting embedded in mobile is going to play a huge part in decision-making as we go forward.

Next Steps

Link: http://searchhealthit.techtarget.com

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The Future of Biotech

by System Administrator - Monday, 15 February 2016, 5:52 PM
 

The future of biotech

by Ryan Bethencourt | Program Director and Venture Partner at IndieBio

“Our world is built on biology and once we begin to understand it, it then becomes a technology.  –Ryan Bethencourt

When most people hear the word biotech they think of syringes, new cancer treatments, and cutting-edge disease therapies. Though this is biotech, it’s just one vertical.

Ryan Bethencourt, a biohacker, entrepreneur, and program director and venture partner of biology accelerator IndieBio, spoke about four primary areas of acceleration in biotech—food, biomaterials, computation, and medicine.

Bethencourt broke down how biology is being applied as a technology in each of these areas and highlighted companies to keep an eye on:

  • Food: Impossible Foodsmaking real burgers that bleed from plant cells. The company recently turned down an acquisition offer from Google for $200 million, so stay tuned.
  • BiomaterialsBolt Threadsbrewing spider silk in yeast and turning it into an outstandingly durable material with applications in the industrial space. The company recently raised roughly $40 million in funds.
  • ComputationKonikupioneering neuron-powered computation by harnessing the power of biological neurons to create the next generation of supercomputers.
  • Medicine: Organogenesis Inc.—developing regenerative medicine such as bioactive wound healing and soft tissue regeneration. Next up in this industry may be the ability to build human organs like lungs and hearts.

More: http://singularityhub.com

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The Future of Health and Medicine: In Your Pocket, Continuous, and Connected to the Cloud

by System Administrator - Monday, 12 October 2015, 9:07 PM
 

The Future of Health and Medicine: In Your Pocket, Continuous, and Connected to the Cloud

By Daniel Kraft

Take a deep dive into the convergence of technology and the future of healthcare at Singularity University's sixth Exponential Medicine program November 9-12th at the magical Hotel Del Coronado in San Diego. Join over 60 world class faculty, 50 startups, for main stage talks, breakout workshops, demos, beachside bonding and more. We are down to our last 50 participant seats, so apply soon. (And to learn more, be sure to check out Singularity Hub's coverage of last year's Exponential Medicine.)

This short video (with some fun integrated graphics) is from an interview I did with El País (the largest newspaper in Spain). It highlights some of the emerging technologies and approaches which have the potential to shift health, medicine and biopharma from an intermittent and reactive physician-centric mode, to an era of more continuous data and a proactive approach in which the individual is increasingly empowered and integrated into personalized wellness, diagnosis and therapy.

The video is below and some associated thoughts follow.

Diagnostics: Era of the Digital Black Bag

Digital diagnostics is coming to the home. Examples range from an eye, ear and throat exam—using connected devices designed for the patient like CellScopeMedWand and Tyto—to cardiac exams enabled by low-cost EKGs (AliveCor and Kito). Some devices will even do automated interpretations (i.e., the EKG interpreted by the app and sent to the cloud) where the diagnosis and management of disease will increasingly be enabled outside of the usual clinic, ER or hospital. Wearable patches that integrate multiple vital signs, such as those developed by Vital Connect and Proteus Digital Health, will enable more complex disease management and monitoring with ICU-level data—EKG, respiratory rate, temperature, position and more—outside of the clinical environment.

Connected, continuous and contextual measurements integrating behaviors detected by smartphone and internet of things (IoT) metrics—ranging from movement to social network activity—will be increasingly used in proactive mental health. Pioneers in this space include Ginger.io and technology platforms like Beyond Verbal (which analyzes the voice to detect emotion).

Altogether, as the sensors, wearables and other elements become commoditized, it will be those platforms that can leverage the data to manage, interpret and create the "check engine light," or "

 that will have the real value in bringing better care at lower costs.

Telemedicine: Beyond Video Chat

Clinical care will increasingly utilize technologies in the home or pocket of the patient or caregiver. The era of the "medical tricorder" (currently being spurred by the $10M Qualcomm Tricorder XPRIZE) will enable far better triage, diagnosis and guiding of therapy than we have available today—often, at best, a digital thermometer. All this will be combined with AI to make sense of the information and trends. Scanadu, with their Scout device, is already in FDA-sanctioned clinical trials with thousands of devices being tested in the field and as part of the XPRIZE competition.

While live chats with a clinician are now common (from MDLive to Doctor On Demand), asynchronous care is coming. New platforms include Curely which enables you to send text and images and allows the clinician to take their time, do research, and provide guidance. Don't want to wait for a dermatologist? Try iDoc24, and send an image of your skin to a dermatologist for a consult.

As payors, payment incentives and larger healthcare systems increasingly get on board with value-based incentives, it will increasingly be your own clinician, not a random virtual one, that you may connect to. Feedback loops connecting patient and clinical care team will also be utilized—as exemplified by HealthLoop—to interact and proactively take action with patients following interventions. This will range from surgery to antibiotic prescriptions to tracking (enhanced with machine learning) chronic disease patients at home as is being pioneered by Sentrian Remote Patient Intelligence.

'Digiceuticals' Pill + App

As apps, the internet of things (IoT) blends with the internet of medicine (IoM), we will go "beyond the pill." Apps will be prescribed with many drugs and other interventions as a means to track, tune and optimize, from diabetes to skin conditions.

Managing anxiety and depression, ADHD and sleep disorders and improving mindfulness and cognition with brain computer interfaces (like the Interaxon Muse) will be integrated with video gaming (as pioneered by Dr. Adam Gazzaley and his UCSF lab). Sometimes the app alone will be the therapy. Omada Health and their app plus connected wearables and a social network aimed at turning around pre-diabetic individuals is an example of effectively prescribing behavior change.

Workflow Is Key for the Clinician

More of healthcare is becoming mediated by digital, connected and mobile health (all buzzwords...soon it will just be health) and augmented with AI and machine learning—but these capabilities won't really become useful until they enter into the clinical workflow. No clinician wants to log into multiple apps or have more raw data to sift.

We are still in the early days. Wearable and other health data is just beginning to flow through smartphones and into the EMR through platforms such as HealthKit. As incentives shift increasingly to value- and outcome-based care, the impetus to prescribe and connect the devices, apps, data and analytics into the clinician dashboard and workflow will become commonplace.

Daniel Kraft, MD is a physician-scientist, chair for medicine at Singularity University, and founder and chair of Singularity University's Exponential Medicine conference.

Image Credit: Shutterstock.com

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The Future of Medicine Is in Your Smartphone

by System Administrator - Sunday, 18 January 2015, 6:36 PM
 

The Future of Medicine Is in Your Smartphone

New tools are tilting health-care control from doctors to patients

 

ELLEN WEINSTEIN

All of this raises serious issues about hacking and personal privacy that haven’t yet been addressed—and the accuracy of all of these tools needs to be tested. People are also right to worry that the patient-doctor relationship could be eroded, diminishing the human touch in medicine. But the transformation is already under way.

Let’s say you have a rash that you need examined. Today, you can snap a picture of it with your smartphone and download an app to process the image. Within minutes, a dedicated computer algorithm can text you your diagnosis. That message could include next steps, such as recommending a topical ointment or a visit to a dermatologist for further assessment.

Smartphones already can be used to take blood-pressure readings or even do an electrocardiogram. ECG apps have been approved by the U.S. Food and Drug Administration for consumers and validated in many clinical studies. The apps’ data are immediately analyzed, graphed, displayed on-screen updated with new measurements, stored and (at an individual’s discretion) shared. I thought I’d seen it all in my decadeslong practice as a cardiologist, but recently, for the first time, I had an ECG emailed to me by a patient, with the subject line, “I’m in atrial fib, now what do I do?” I immediately knew that the world had changed. The patient’s phone hadn’t just recorded the data; it had interpreted it.

Now, at any time of day or night, you can demand and get a secure video consultation with a doctor via smartphone at the same cost (about $30-$40) as the typical copay charge through employer health plans. This may seem exotic now, but several large consulting firms—including Deloitte and PricewaterhouseCoopers—have forecast that virtual physician visits (replacing physical office visits) will soon become the norm. Deloitte says that as many as one in six doctor visits were already virtual in 2014. In many U.S. cities, you can even use a mobile app to request a doctor’s house call during which a physician would not only provide a consultation but could even perform procedures, such as suturing a wound, which would have usually required an expensive emergency room visit.

 

With innovative digital technologies, cloud computing and machine learning, the medicalized smartphone is going to upend every aspect of health care. AGENCE FRANCE-PRESSE/GETTY IMAGES

Many surveys show that most consumers want to get information about the actual costs of their care from their doctors but can’t get it. Going forward, what things cost will no longer be the great unmentionable hanging over medicine: Cost-transparency apps for your smartphone already exist and are quickly being expanded to cover lab tests, scans, procedures, hospitals and doctor visits.

Even bigger changes are in the works. Using wearable wireless sensors, you can use your smartphone to generate your own medical data, including measuring your blood-oxygen and glucose levels, blood pressure and heart rhythm. And if you’re worried that your child may have an ear infection, a smartphone attachment will let you perform an easy eardrum exam that can rapidly diagnose the problem without a trip to the pediatrician.

These innovations are just the start. In the next year or two (depending on approval by the FDA), many Americans will probably start sporting wristwatches that continuously and passively capture their blood pressure and vital signs with every heartbeat, without even having to press a start button.

Such wristwatch sensors could do enormous good. By having the equivalent of intensive care unit monitoring on your wrist, hospital rooms—those $4,500-a-night risk zones for serious infections and other complications—can be replaced by our bedrooms. As a result, except for ICUs, operating rooms and emergency rooms, hospitals of the future are likely to be roomless data surveillance centers for remote patient monitoring.

Other wearable sensor tools now being developed include necklaces that can monitor your heart function and check the amount of fluid in your lungs, contact lenses that can track your glucose levels or your eye pressure (to help manage glaucoma), and head bands that can capture your brain waves. Someday, socks and shoes might analyze the human gait to, for instance, tell a Parkinson’s patient whether his or her medications are working or tell a caregiver whether an elderly family member is unsteady and at risk of falling.

We know that our health is highly influenced by our environment, which has been difficult to quantify. But smartphone sensors under development will be able to monitor your exposure to radiation, air pollution or pesticides in foods. And your medications could soon be digitized to provide you with reminders to ensure that you’ve taken them as prescribed.

It isn’t just hospitals’ rooms that are on their way out; so are their labs. Smartphone attachments will soon enable you to perform an array of routine lab tests via your phone. Blood electrolytes; liver, kidney and thyroid function; analysis of breath, sweat and urine—all can be checked with small fluid samples in little labs that plug directly into smartphones. And you can do your own routine labs at a fraction of the current cost.

Smartphone selfies are all the rage, but smartphone physical exams are just taking off. The ability to make a definitive DIY diagnosis of an ear infection with a phone is just the first step. Apps are now being developed to handle all aspects of the eye, the throat and oral cavity, and the lungs and heart. Meanwhile, nearly all sophisticated medical imaging devices are being miniaturized: Hand-held ultrasound devices are already available, and some medical schools have begun issuing them in the place of the old-school stethoscope. Hand-held MRI (magnetic resonance imaging) machines aren’t far behind, and engineers at UCLA have come up with a smartphone-sized device that can generate X-rays. It won’t be long before you can take a smartphone X-ray selfie if you’re worried that you might have broken a bone.

In the next decade, you—under select circumstances, involving high risk or major medical need—will be able to monitor almost every organ system, no matter how difficult to access, as firms start to produce nanosensors to be embedded in your bloodstream. These microscopic sensors within your body can float in blood or be fixed to a microstent in a tiny blood vessel. You’ll then be able to keep your blood under constant surveillance for the first appearance of cancer, autoimmune attacks on vital tissues or the tiny cracks in artery walls that can lead to heart attacks or strokes.

With all these new tools, it is no surprise that we’re talking about the possibility of “doctorless” medicine. Let’s not get too carried away. You’ll still be seeing doctors—but you’ll have a lot more control.

That change is badly overdue. Medicine has long been dominated by a priestly class, beginning with Imhotep, the first physician (and a priest), in Egypt some 4,600 years ago. Things had hardly changed two millennia later when Hippocrates, widely considered the father of medicine, held that most medical information should be concealed from patients.

Hippocrates’s paternalistic sentiments survive today in our culture’s pervasive sense that “doctor knows best.” Physicians obviously tend to think so, but that sentiment is also powerfully reinforced by the top-down way medical information flows (or clogs). The vast majority of doctors are unwilling to email patients or share their office notes. Getting a copy of a report after lab tests or medical scans seems impossible—and don’t even think about getting the results or images themselves. That is all about to change.

We’re often told that the U.S. faces a big looming shortage of physicians. The expansion of DIY medical capabilities certainly challenges that notion: We may end up not having a physician shortage at all.

But one discipline already has an unequivocal dearth of health-care professionals: mental health, which is also the leading cause of disability in the U.S. and many other developed countries. Smartphones can be particularly helpful here. New apps aim to quantify your state of mind by a composite of real-time data: tone and inflection of voice, facial expression, breathing pattern, heart rate, galvanic skin response, blood pressure, even the frequency and content of your emails and texts.

We may soon take an even bigger step forward, thanks to the unexpected advantages of virtual psychiatrists. Recent studies, including a paper by Gale Lucas and others published last year in the Journal of Computers in Human Behavior, have demonstrated that people are more willing to disclose their inner thoughts to a computer avatar or “virtual human” than a real one. With machines working to quantify moods and even offering virtual counseling to help make up for our current profound shortage of mental health professionals, we can glimpse a new approach to improving mental health.

This is heady stuff—but this vision of medicine also raises some serious and reasonable concerns. Before these tools enter widespread use, they must all be validated through clinical trials and shown to not only preserve health but to do so while lowering costs. Without such validation, the whole promise of digital medicine will be for naught.

Moreover, while we may find cases in which it is easier to tell things to a digital avatar, we can’t rely on avatars as doctors, powered by DIY physical exams and lab tests alone. These new high-tech tools can provide useful medical information directly, quickly and inexpensively to consumers. But physical visits with doctors will never be replaced for important, serious matters that require face-to-face conversations—and no keyboards.

Even as we’re making great strides in capturing personal medical information, we’re way behind in dealing with the data deluge. We’ve done far too little to protect our precious personal health data’s privacy, stop it from being sold to third parties or secure it from hacking. We’re also pathetic at data analytics: We tend to hoard big data and have done relatively little to extract meaningful information from it. To make matters even more complicated, none of the new patient-generated data—from sensors, lab tests, self-exams, DNA sequencing or auto-imaging—is flowing into the traditional hospital- or doctor-owned electronic health records.

I think all these problems can be managed, but it will take work. And these obstacles shouldn’t dissuade us from seizing the progress that is at hand.

The real revolution doesn’t come from having your own secure, in-depth medical data warehouse on your smartphone. It comes from the cloud, where we can combine all our individual data.

When that flood of data is properly assembled, integrated and analyzed, it will offer huge new potential at two levels—the individual and the population as a whole. Once all our relevant data are tracked and machine-processed to spot the complex trends and interactions that no one could detect alone, we’ll be able to pre-empt many illnesses.

Take asthma attacks. A teenager who’s prone to wheezing in gym class could get comprehensive data on environmental exposures such as air quality and pollen count, along with data on physical activity, oxygen concentration in the blood, vital signs and chest motion; their lung function can be assessed through their smartphone microphone, and their nitric-oxide levels can be sampled via their breath. Then that information could be combined with the data from every other tracked asthma patient—and trigger a warning, delivered by text or voice message on the teenager’s phone, that an attack is imminent and tell the teenager which inhaler would prevent it.

The same type of procedure could prevent heart failure, seizures, severe depression and autoimmune disease attacks. It could save countless lives.

Finally, we simply cannot imagine what we’ll learn from the brave new world of open medicine: massive online information resources that pull together data from millions and eventually billions of individuals. Think of Facebook’s ability to obtain social data from more than a billion people—but now imagine pulling together medical information never previously aggregated or even acquired. A person who develops a new illness could use an open-medicine resource to find their nearest “neighbor”—the individual who most closely resembles their condition—to help determine the best treatment.

Putting hundreds of sensors into cars and providing exquisite computer navigational support didn’t just produce autonomous cars; it also made them safer than old-school, lower-tech cars driven by humans. The same combination of sensors and computing power is about to do something similar to medicine—transforming it from a weakly evidence-based practice to a data science, with empowered individuals at center stage.

As more medical data is generated by patients and processed by computers, much of medicine’s diagnostic and monitoring aspects will shift away from physicians like me. The “doctorless” patient will remain in charge, turning to doctors chiefly for treatment, guidance, wisdom, experience, empathy and the human touch. These doctors won’t write orders; they’ll offer advice.

Just as the printing press democratized information, the medicalized smartphone will democratize health care. Anywhere you can get a mobile signal, you’ll have new ways to practice data-driven medicine. Patients won’t just be empowered; they’ll be emancipated.

Dr. Topol is a cardiologist and the director of the Scripps Translational Science Institute in La Jolla, Calif. He is the author, most recently, of “The Patient Will See You Now: The Future of Medicine Is in Your Hands,” published by Basic Books. He consults for Google, AT&T, Walgreens, Quanttus and Sotera Wireless on many of the issues discussed and sits on the board of directors of Dexcom.

Link: http://www.wsj.com

 

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The Home Microbiome Project

by System Administrator - Monday, 1 September 2014, 7:46 PM
 

The Home Microbiome Project

BACTERIA FROM NEW RESIDENTS POPULATE HOMES WITHIN ONE DAY, ACCORDING TO STUDY

Written By: David J. Hill

Worried about leaving a digital footprint behind? Your bacterial footprint could be much worse and even incriminating.

Recently, researchers traced the microbes that live on and around people within their homes. Findings from the study showed that the composition of indoor microbe communities is significantly affected by people and changes rapidly with their presence or absence.

For example, after three of the families moved into new homes, it took less than 24 hours for the microbes to spread, to the extent that the new home looked microbially the same as the previous home. One of the couples who moved had been staying in a hotel–their new home was rapidly populated with the microbes from the hotel room.

The results serve as another insight into a complex relationship between humans and the bacteria that live in, on, and around us.

We want to know where these bacteria come from,” said microbiologist Jack Gilbert, who led the study at Argonne National Labs as part of the Home Microbiome Project, in the press release. “As people spend more and more time indoors, we wanted to map out the microbes that live in our homes and the likelihood that they will settle on us.”

The Home Microbiome Project is an initiative aimed at uncovering the dynamic co-associations between people's bacteria and the bacteria found in their homes.The hope is that the data and project will show that routine monitoring of the microbial diversity of your body and of the environment in which you live is possible.

The research, recently published in the journal Science, was conducted over the course of six weeks. Participants included 18 people within 7 diverse American families that were recruited on Twitter for the study. There were even three dogs and one cat in the mix.

Participants swabbed their hands, feet, and noses daily as well as various surfaces in their dwellings, such as light switches, doorknobs, countertops, and floors. The samples were then sent to Argonne for DNA analysis. The composition of bacteria was most similar on hands, given the number of common surfaces people share, while noses showed more unique compositions. Furthermore, closer relationships showed more microbe sharing–whether between couples or even parents and their young children.

In one instance, bacteria called Enterobacter (known to infect immunocompromised individuals) was traced passing from one person’s hand to a countertop then to another person’s hands. The researchers commented that though we may be exposed to pathogens routinely, disease may only result when the immune system is disrupted in some way.

Mounting evidence suggests that the human-microbiome relationship may affect physical and mental health, such as obesity, along with development. In one recent study,gut bacteria from thin and obese mice can induce weight loss or gain in normal mice.

“We know that certain bacteria can make it easier for mice to put on weight, for example, and that others influence brain development in young mice,” Gilbert said. “They are essential for us to understand our health in the 21st century.”

 

Unravelling the mystery of the human microbiome will take some time due to the complexity of the composition. One startup called uBiome recently raised $4.5M from investors to sequence the human microbiome after bringing in $350,000 via a crowdfunding campaign in 2012. Scientists recently reported that 10 million genes of the microbiomehave now been sequenced.

Along with considering the health implications of these findings, the researchers noted that our microbiomes were characteristic, meaning that the microbial composition is enough to identify at least the family that left it behind. Hence, microbiome analysis could be helpful in forensics. Because the microbial community changes after a person leaves a house, “You could theoretically predict whether a person has lived in this location, and how recently, with very good accuracy,” Gilbert said.

Though it will take a number of years for the microbiome to be understood, the implications of this research are deep. With all the attention in the world of technology on data to understand everything about humans, it may be the tiniest of living things that speak volumes.

[Media credit: Home Microbiome Project/Argonne National Lab, Human Genome via Science]

This entry was posted in Longevity And Health and tagged Argonne National Labsbacteriaforensic toolshome microbiome projectmicrobiome,uBiome.

Link: http://singularityhub.com

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The House Call of the Future

by System Administrator - Monday, 1 September 2014, 7:29 PM
 

The House Call of the Future – Breakaway Thinking

 

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.

The closest I’ve come to experiencing a house call was watching Dr. Baker on “Little House on the Prairie” visit the good folks of Walnut Grove. Today, most people have no choice but to trek to their doctors’ offices and hospitals for health maintenance, diagnoses and check-ups. But new technologies are returning the personalized attention of the house call and will need to be adopted to retain the convenience and accessibility they offer.

I haven’t met anyone with a practice like Dr. Baker’s, though I recently read a news article that highlights the comeback of the house call. Some practitioners are banding together to provide round-the-clock care to patients who benefit from the fast response and lower cost: If a deductible or copay is higher than the price of the doctor’s visit, the patient may opt for the home visit.(1) The updated versions of the house call, however, are born of the technology used for telehealth, mobile health and health stations.

Telehealth allows a person to connect with a provider via the Internet. Patient and doctor can video conference, share informational media, and experience a face-to-face interaction without either party traveling from his or her home or office.(2) This allows patients better access to specialists who may have been too far away to visit and more frequent care at the right time to reduce the chances of serious complications or hospitalization. For patients who require frequent care over time, telehealth enables them to receive the medical attention they need while staying near their support network.(4) For providers, access to networks of specialists who can provide remote consultation helps them retain and ensure the highest level of care for patients rather than refer patients to another location.(3)

Both patients and providers also save time and money when there is no commute to an office or to a patient’s home. This is especially true of patients who live in rural areas and have to travel long distances for care. The quicker a patient can connect with the right specialist to treat or prevent serious illness, the lower the overall cost of care. (3)

 

Mobile health, or mHealth, takes technology one step further by allowing providers to track and monitor patient health on mobile devices such as tablets or phones. This includes monitoring devices that measure heart rate, blood pressure, oxygen levels, blood glucose and body weight. mHealth can be used in the office or taken on the road the way mobile clinics do. When healthcare is mobile, the ability to bring a doctor’s office to a neighborhood gives access to communities that otherwise wouldn’t seek or know how to find care. Currently, all 50 U.S. states have mobile clinics.(4)

Another trend in the making is the health kiosk. These look like private pods, about the size of four phone booths side by side. Think of it as telehealth combined with a mobile clinic. HealthSpot, a provider of health kiosks, describes them as “the access point to better healthcare.”(5) In addition to providing interaction with healthcare professionals via video conferencing, each station has an attendant and an automatic cleaning system. HealthSpot aims to give patients a private, personal, efficient experience.

Healthcare is on the move to better accommodate our lives, schedules, family structures and communities, which have vastly evolved from the “Little House on the Prairie” days and even from a decade ago. At the same time, our industry faces challenges in making the new technologies simple to use in order for them to be effective. With telehealth, for example, people typically need help setting up a home system and technical assistance. Meanwhile, providers face communicating and documenting in a new environment.

As we enter this new, modern, faster era of healthcare, both patients and providers will need to learn how to implement and adopt new systems, technologies and ways of interacting. Easing adoption is what we are prepared to do at The Breakaway Group. Once the learning-and-comfort curve is overcome, patients can experience the convenience of Dr. Baker’s updated home visit.

 

References:

(1) Godoy, Maria, (December 19, 2005). A Doctor at the Door: House Calls Make Comeback.
(2) Health Resources and Services Administration Rural Health, (2012). Telehealth.
(3) Hands on telehealth, (2013). 15 Benefits of telehealth.
(4) Hill, C., Powers, B., Jain, S., Bennet, J., Vavasis, A., and Oriol, N. (March 20, 2014). Mobile Health Clinics in the Era of Reform.
(5) The HealthSpot Station.

Xerox is a sponsor of the Breakaway Thinking series of blog posts.

Related Posts:

  1. Virtual House Call – Web Cam Based Clinical Visit
  2. Healthcare Innovation in a Brave New World – Breakaway Thinking
  3. EHR Adoption: Step One to Successful Population Health Management – Breakaway Thinking
  4. Meaningful Use Playbook 2014: Overcoming Adversity – Breakaway Thinking
  5. Healthcare Super Bowl – Winning with EHR Adoption – Breakaway Thinking

Link: http://www.emrandhipaa.com

 

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

 

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The Impact of Sensors in Healthcare on Patient Care

by System Administrator - Sunday, 5 July 2015, 8:13 PM
 

Infographic: The Impact of Sensors in Healthcare on Patient Care

by


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The Local Imperative: Understanding the Influence of Local Stakeholders on Prescribing and Treatment Decisions

by System Administrator - Wednesday, 15 October 2014, 9:11 PM
 

 

The Local Imperative: Understanding the Influence of Local Stakeholders on Prescribing and Treatment Decisions

With healthcare increasingly adopting a greater focus on care quality and health outcomes, traditional payment models continue giving way to new approaches. The advent of provider networks such as integrated delivery networks (IDNs) and accountable care organizations (ACOs) are reshaping the way care is provided and how clinical decisions are made.

In a new white paper entitled, "The Local Imperative: Understanding Emerging Physician Stakeholders & Their Influence on Prescribing and Treatment Decisions," IMS Health addresses how life sciences companies can no longer view the U.S. as a national market — or pursue it with a single brand strategy and individual, physician-focused sales and marketing tactics.

Please read the attached whitepaper.

 

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The medical profession needs to get over its fear of information technology

by System Administrator - Sunday, 29 March 2015, 8:08 PM
 

The medical profession needs to get over its fear of information technology

Continued objections to Electronic Health Records ( EHR) by sections of the physician community are bogus. They arise from past entitlements and a lack of accountability

by Paddy Padmanabhan | CIO

In a recent article in a national publication, a member of our physician community raked up a debate by declaring the Electronic Health Records (EHR ) mandate to be a debacle and argued that EHR’s actually harm patients.  These are bogus objections that continue to be raised by a community that clings to its past entitlements and easy money attached to little or no accountability. But it also exposes an undercurrent of resistance to change that the general public should be worried about.

Under the provisions of Obamacare, The Center for Medicare and Medicaid Services (CMS) has mandated the use of EHR technologies for qualifying for additional incentives under Meaningful Use criteria. This includes maintaining patient medical records, sharing them with patients as well as other health systems, and using them for treatment decisions. Individual physicians and practices now have to comply as well, and a failure to implement EHR’s within a certain date will result in Medicare reimbursements being reduced by 1-5 percent progressively with time till the end of this decade.

According to a Rand Corporation study, the three key objections against the implementation of EHR’s:

--It costs too much to implement an EHR system: Yes, it costs money to implement any new software. Given a choice, physicians would prefer not to use email or even the telephone because all of these things cost money and have no direct relation to the treatment of patients. What these same physicians also fail to mention is that large hospital systems have been extending significant subsidies to small physician practices in order to help them address the costs.

--It takes time away from patient care: Physicians love to talk about how much they care about being with their patients. However, they also routinely overbook their schedules with the sole intention of increasing patient visits and claiming additional reimbursement. EHR’s can actually aid their productivity by reducing the time it takes to pull up medical history, so that they have more time to spend on actually talking to their patients.

--EHR systems are hard to use and are not secure: There may be some merit to this. No one is making claims that EHR systems are perfect.

In sum, it would appear that their primary argument is that the implementation of EHR’s results in lower quality of care and higher costs.

However, there are a few key aspects that these physicians prefer to not acknowledge when making these arguments:

--Shared electronic medical records can reduce expenses: Physicians routinely bill for duplicate medical expenses, such as tests, that would be avoided if the test results can simply be pulled up electronically. This should logically reduce healthcare costs at a system level.

--Quality of treatment can improve significantly: When a complete medical record is available about a patient, including details of visits to multiple healthcare professionals, the quality of diagnosis and hence treatment decisions should improve greatly. This improves patient safety and reduces medical errors, since everyone has access to the same set of data.

--EHR’s can enable preventive diagnosis and early intervention that reduces costs and improves patient health: Enter healthcare analytics. Having patient medical records in an electronic system enables this data to be analyzed for preventive and early action, improved disease management, and reduced hospitalizations. The whole notion of population health management rests on this premise and is hard to argue with.

At the end of the day, the biggest benefits of technology will accrue from our ability to integrate patient medical information from EHR systems, and analyze them in conjunction with data that is going to be available through wearable devices and other consumer health technologies. If some parts of our physician community do not get this, we need to leave them behind and move on.

This article is published as part of the IDG Contributor Network. Want to Join?

Paddy Padmanabhan | IDG Contributor Network 

Paddy is an experienced and accomplished business leader & entrepreneur with over 25 years of experience. He has worked extensively in Technology and Analytics in the Healthcare sector. Paddy is CEO of Damo Consulting Inc, an independent management consulting firm providing technology, outsourcing and analytics advisory services to healthcare enterprises..

Link: http://www.cio.com

 

 

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The Role of Linux in Datacenter Modernization

by System Administrator - Tuesday, 12 August 2014, 5:45 PM
 

IDC Whitepaper: The Role of Linux in Datacenter Modernization

Industry changes, technology advancements, and changing applications - these are all factors that have made the datacenter an IT investment that is always evolving. And as the IT environment becomes more complex, datacenters will require intensive modernization strategies that go beyond simply expanding floor space. This IDC whitepaper examines how today's datacenters are adapting to and leveraging changing technologies and how Linux can act as an enabler for this evolution. Read on and learn more about Linux's evolving role in the datacenter now and in the future.

Please read the attached whitepaper

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The Secrets of Optimizing your EHR

by System Administrator - Friday, 19 June 2015, 1:28 PM
 

The Secrets of Optimizing your EHR

Unlock the Power of Your EHR! Gain leverage by optimizing your EHR. That’s what EHR optimization is all about. Creating leverage for your practice to be all it can be for your patients, your staff, and you! This eBook will summarize best practices for fine tuning your EHR system.

Please read the attached whitepaper.

 

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The Value-Based Hospital

by System Administrator - Tuesday, 16 September 2014, 9:26 PM
 

Value-based model could improve hospital performance 30%

The Value-Based Hospital

 

by Elisabeth HanssonBrett SpencerJames KentJennifer ClawsonHeino Meerkatt, and Stefan Larsson

  • The value-based hospital a far more effective way of delivering health care and running a provider organization.
  • BCG has been working with the pioneers to understand the key success factors in the value-based hospital.
  • Our work with a growing number of hospitals to adopt the value-based operating model shows that it is possible to see positive results quickly.

Health care providers all over the world face an extraordinary combination of pressures. Despite decades of cost containment and other operational-improvement initiatives, costs continue to rise, putting unrelenting pressure on hospital budgets. The tight management of department budgets and clinical processes is further complicating already complex organizations, leaving staff demoralized and disengaged. At the same time, markets are becoming more competitive. Countries with public-health systems, such as the UK, are encouraging privatization; meanwhile, in the U.S., where the private sector already plays a major role, providers are becoming more consolidated. Payers everywhere are calling for more transparency on actual health outcomes and experimenting with value-based reimbursement. Patients are becoming more demanding and exercising more choice.

In response to these pressures, a few pioneering organizations are developing a new operating model that we call the value-based hospital. These providers are taking a fundamentally different approach to continuous improvement by monitoring the health outcomes of specific patient groups and understanding resource requirements and costs in the context of how those outcomes are achieved along the clinical pathway. And they are using the provision of better health outcomes and greater health-care value (defined as the ratio of outcomes to costs) as ways to drive the organizational improvement agenda and differentiate themselves from their provider peers. The focus on outcomes and value delivered has created a shared language that allows broad groups of staff to pursue common goals and increases collaboration to achieve those goals. Among the leading organizations that have embraced this approach areKaiser Permanente and Cleveland Clinic in the U.S., Martini-Klinik and Schön Klinikin Germany, and Terveystalo, the largest private health-care provider in Finland.

Cleveland Clinic’s CEO, Dr. Toby Cosgrove, has called the value-based approach a“breakthrough that will change the face of medicine.” The vast majority of hospitals, however, have yet to embark on this journey. Despite years of quality management initiatives, hospitals are decades behind most other industries.

We believe that the value-based hospital is more than yet another improvement initiative. Relative to past efforts, it is a far more effective way of delivering health care and running a provider organization—one that puts patients and their outcomes at the center of a hospital’s operations; that relies on the engagement, leadership, and cooperation of the hospital’s clinical community; and that makes possible a more constructive interaction between hospital management and clinicians as they take joint responsibility for the delivery of cost-effective, quality care.

The Boston Consulting Group has been working with the pioneers to understand the key success factors in the value-based hospital. What’s more, our work on the ground supporting a growing number of hospitals in their efforts to adopt this new operating model demonstrates that it is possible for any hospital, no matter what its starting point or regulatory environment, to move in the direction of value-based, continuous improvement quickly and to see positive results early. A hospital does not need to first have all the data and systems in place to see results. Simply bringing together the right people, who are committed to improving patient outcomes, in a structured process can lead to significant improvements. In our client work, we have seen organizations achieve productivity and other improvements of approximately 30 percent in just three months.

In this article, the first in a series, we describe the advantages of the new value-based operating model for hospitals and other health-care providers. In subsequent articles, we will provide examples of some of our recent client work in the U.S. and Europe to help organizations introduce the value-based approach and propose a six-step transformation agenda for any provider that seeks to put value for patients at the center of its strategy and offering.

The Limits of the Traditional Hospital Operating Model

The value-based hospital is a fundamentally different and better way to run a hospital, track performance, and organize care. To understand why, it pays to explore the typical ways that hospitals organize and manage care.

Every hospital wants to deliver quality care in a cost-effective fashion. But the way most hospitals are organized today makes that goal very difficult—and, in many cases, nearly impossible—to achieve.

Three organizational characteristics, in particular, stand in the way of sustainable continuous improvement.

Functional Organization. In many respects, the typical hospital is the last bastion of the traditional functional organization. Departments are organized by medical specialty: cardiology, thoracic surgery, rheumatology, radiology, and so on. In many hospitals, resources that could be shared, such as emergency care, intensive care, and surgery, are likewise organized into their own specialty units. Despite the high degree of formal interaction among departments through referrals for diagnostics or treatment, each unit is measured on its own budget and its own organizationally distinct KPIs. What’s more, incentives are typically not shared across departments or care units.

This highly functional organization structure made sense in an era when the primary means of improving health care delivery was to increase the specialization and unique expertise of a hospital’s clinicians and when choosing among diagnostic and therapeutic alternatives was far simpler. But that functional organization structure comes with a major organizational downside: the relative independence of separate specialized units makes it extremely difficult to optimize the full care pathway and manage costs in an integrated fashion. Although individual-unit performance and costs can be tracked, no one unit typically has responsibility for the health outcomes of a given group of patients across the entire care chain. There can even be negative incentives for the clinicians in one unit to collaborate with those in another. Handoffs between units often require duplicating data and work (classic examples are the duplication of lab tests, patient interviews, and examinations).

Narrow Performance Metrics. The problems of the rigid functional structure are exacerbated by the type of performance metrics that hospitals typically collect. In our experience, most hospitals track financial metrics (by department, usually in terms of whether a given unit is on budget) and process metrics (with an emphasis on waiting times and the productivity of individual units). Some measure “quality,” but when they do, quality is often defined as compliance with treatment guidelines (in effect, process efficiency) or assessed using surveys about the patient experience. But those approaches emphasize efficient throughput or subjective experience, not the actual health outcomes delivered to patients suffering from a particular disease or undergoing a specific procedure. The fact that costs for a given condition are distributed across many different departments makes it extremely difficult to get a clear picture of the whole and, therefore, to act on costs, because nobody “owns” or can manage the trade-offs between cost and quality along the clinical pathway.

The Management-Clinician Divide. A highly fragmented organization and metrics that do not directly address the key purpose of the organization—improving the health and well-being of patients—tend to create a cultural disconnect between the management of the hospital and its clinical staff. Administrators of individual units focus on maximizing the efficiency of their own units through their control over the budget and staff schedules. Meanwhile, clinicians aspire to achieve the best clinical outcome for their individual patients but have little control over the budget and schedules and little useful data about patient outcomes and the specific costs that do—and don’t—make a difference in delivering those outcomes.

This behavior in hospitals is not the result of some inherent unwillingness to cooperate. Rather, it is a logical consequence of the resources made available to the different actors in the hospital system and the constraints they face when trying to achieve their goals. Indeed, participants on either side of the divide often complain about the constraints that the traditional operating model imposes. On the one hand, hospital administrators often feel powerless to influence clinicians, who are on the front line of care. On the other hand, highly committed clinicians often feel not only that the metrics and objectives the system imposes on them have little to do with patient care but also that they lack the information and tools needed to really make a difference in hospital performance. The management-clinician divide is the result of these misaligned goals, resources, and constraints, which are a consequence of the traditional organization and operating model.

The Advantages of the Value-Based Operating Model

The value-based operating model is fundamentally different. Its starting point is a commitment to collect and share data on the actual health outcomes that the hospital delivers to patients.

Systematically tracking outcomes is essential for two primary reasons. First, delivering quality health outcomes is the raison d’être of any provider organization. Quality health outcomes are what patients want from their providers and what payers ultimately should fund. Second, and perhaps even more important, not until an organization knows what kind of outcomes it is delivering can it begin to understand its true performance and what kind of value it is providing—that is, the level of outcomes delivered for a given cost.

Focusing on outcomes also has a third big advantage. It provides both administrators and clinicians with a whole new way to think about costs: whether the costs incurred actually contribute to outcomes that matter to patients.

Costs That Matter to Patients. By definition, health outcomes are specific to a given disease, medical condition, or procedure. The outcomes that matter vary by patient group. Similarly, the costs that matter in the value-based hospital are the costs per patient to achieve the target outcomes for a given disease or condition.

Therefore, the right way to track costs is not so much by each specialized unit but bythe activities undertaken and resources used for a given patient group across the entire care-delivery process. (See Exhibit 1.) Once an organization has developed a system for tracking the cost per patient in a particular group of patients suffering from the same disease or condition or with a similar medical profile, it is in a position to identify which particular costs drive quality outcomes and which do not.

 

The Power of Clinician Engagement. Because clinicians care about delivering high-quality outcomes, focusing on outcomes is a powerful mechanism for engaging clinicians in the value-based improvement agenda. Indeed, without genuine clinician engagement over an extended period of time, no change is likely to be sustainable.

Clinicians are the key influencers in any hospital organization. The clinical staff is closest to the patient and knows how things are really done. Indeed, without clinicians’ commitment to a change effort, it is unlikely to get off the ground or prove sustainable over time. Most important, only by engaging the clinical community—up and down the hierarchy and across the entire care-delivery chain for a given disease or condition—can a hospital begin to break down the organizational barriers between departments in order to truly collaborate and share knowledge and ideas for improvement.

The combination of new visibility about outcomes and costs per patient group with across-the-board engagement on the part of clinicians creates the context for a new kind of behavioral dynamics in the hospital. New health-outcomes data and cost data that together provide an integrated perspective across the entire care-delivery value chain give clinicians new resources for care innovation. These data also make it possible to align the clinical goal of delivering high-quality care with the managerial goal of delivering that care as cost-effectively as possible. Put simply, clinicians in this context find that it is in their interest to cooperate with one another and with management in a genuine partnership in which each takes joint responsibility for providing quality outcomes in a cost-effective fashion.

Developing Sustainable Competitive Differentiation. Once a hospital has the right patient-focused metrics in place and an engaged clinical staff operating on the basis of effective processes for care redesign, it is also in a position to identify its areas of strength and leverage those strengths to establish its competitive differentiation in the rapidly changing health-care marketplace. By “competing on outcomes,” a hospital can attract more patients, generate better economics, and develop a sustainable response to the trends that are transforming health care. (See Exhibit 2.)

 

In some cases, a provider organization will focus on becoming an international leader in treating a specific condition that often requires highly specialized care—for instance, prostate cancer. Providers that use this strategy leverage their depth of experience in clinical-practice R&D, excel at systematically driving outcomes improvements that matter for patient groups, and increase volume by attracting new patients who want the highest-quality outcomes.

In other cases—for example, chronic diseases such as diabetes or congestive heart failure—providers will strive to become integrated-service institutions that take responsibility for the entirety of patient health in a given population across primary, secondary, and in some cases tertiary care. The integrated providers will manage the population for maximum health-care value and will, to a large extent, manage their own integrated care chains. But they will also act as brokers, helping their patients navigate to the best independent providers, which align their approaches with the integrated providers’ systems and offer unique capabilities.

The Value-Based Hospital and Translational Medicine

For academic medical centers, the increased focus on measuring and understanding patient outcomes comes with an added benefit: the opportunity to achieve better connections between research and health care delivery. Over the past 15 years, so-called translational medicine—“from bench to bedside”—has been a major goal of biomedical research. And yet, the traditional model of health care delivery—with its functional organization of specialist departments, its increasing focus on productivity rather than quality of care, and its weak data management—is not well suited to the demands of clinical research, even in a university hospital setting. This disconnect has been a major reason for the declining number of clinical trials in many countries.

Most medical research focuses on diseases and patient groups, on measuring end results and outcomes, and on strict data management and analysis. The requirement to collect data separately—outside the everyday care-delivery process—has not only made research expensive but also created a cultural barrier in which research is often considered a special interest with a limited direct linkage to the improvement of clinical practice and, ultimately, health outcomes.

When the measurement of real-world health outcomes is part of care delivery, however, it becomes possible to fully align research and clinical practice. A good example of this principle is the recent use of large, low-cost, registry-based, randomized clinical trials in which outcomes data collected routinely by disease-specific quality registries is used to assess the effectiveness of existing clinical practices and treatments.

For instance, a team of Swedish, Danish, and Icelandic researchers recently conducted a “multicenter, prospective, randomized, controlled, open-label clinical trial” to test the effectiveness of coronary-artery thrombosis aspiration, a technique that is increasingly used along with percutaneous coronary intervention (PCI) for patients suffering from ST-segment-elevation myocardial infarction (STEMI), a type of heart attack. The trial enrolled 7,244 STEMI patients from the comprehensive Swedish Coronary Angiography and Angioplasty Registry. The patients were randomly assigned to receive either manual thrombus aspiration followed by PCI or PCI alone. The study found that routine thrombus aspiration before PCI did not significantly reduce mortality and, therefore, did not contribute to health care value. 

To Contact the Authors:

Link: https://www.bcgperspectives.com

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THREE METHODS HEALTHCARE TECHNOLOGY LEADERS USE TO SUCCEED

by System Administrator - Wednesday, 6 May 2015, 3:13 PM
 

THREE METHODS HEALTHCARE TECHNOLOGY LEADERS USE TO SUCCEED

Technology is taking center stage as an integral part of the overall care delivery system, creating a new level of demand on high-level IT experts. In this eBrief we explore how some of the top healthcare IT leaders are successfully navigating this changing landscape.

"We are now starting to use technology to create operational excellence, whereas before we were just putting in applications." - Charles Christian | CIO at St. Francis Hospital  

Whether you’re a CMIO, a CIO, or an IT VP/Director, it’s no secret that the workload and challenges of your position have been increasing at a record pace over the last several years. From government initiatives such as Meaningful Use to the everyday functioning of code calls in your hospital, more and more projects are dividing your time and attention. And beyond being a specialist in your individual field, you are now expected to be equal parts technology expert, business executive, and social psychologist. 

In an EMR world, the work of technology leaders in healthcare has become further complicated by the question of how to bring multiple systems and information pathways together for simplified workflows that support faster, more efficient, and safer patient care. Charles Christian, CIO at St. Francis Hospital in Columbus, Ga., noted that he is now involved in most operational meetings at his organization, not to discuss technology, but to discuss process. "We are now starting to use technology to create operational excellence, whereas before we were just putting in applications." 

And Ed Marx, Former CIO at Texas Health Resources in Arlington, said that with the digitization of information, technology now infiltrates nearly everything. "We put in these systems. How do we optimize our investment? How do we make sure everything is integrated?" 

This expanded view of technology as an integral part of the overall care delivery system creates a whole new level of demand on high-level technology experts. So how are some of the top healthcare IT leaders navigating this changing landscape? In this eBrief, we explore some of the ways experienced healthcare IT experts prioritize projects, the skills they employ to be successful, and some of their tips to stay afloat. Then we offer an enterprise-wide communication example that applies these skills.

Please read the attached whitepaper.

 

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Tips for high availability

by System Administrator - Monday, 7 August 2017, 12:40 PM
 

Tips for high availability

Sponsored by Veeam Software 

In healthcare, availability is not important, it's essential. Inside, learn how digital transformation has disrupted how Healthcare organizations manage their IT, as well as 6 tips to ensure availability.

Please read the attached whitepapers.

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Top 5 Digital Health Categories Poised for Growth in 2015

by System Administrator - Thursday, 15 January 2015, 7:49 PM
 

Top 5 Digital Health Categories Poised for Growth in 2015

Is digital health an investment bubble set to burst? Rock Health’s Malay Gandhi weighs in.

The ball may have dropped on another new year, but 2014 was known as the year venture funding picked up the ball and ran for it— when it came to digital health. According to a recent report released by Rock Health, a record total of more than $4 billion was poured into the space last year, and it’s poised to keep on growing in 2015.

 

Malay Gandhi, Managing Director at Rock Health

“This is not a bubble,” said Malay Gandhi, managing director at Rock Health who leads and works closely with portfolio companies. “We are in the middle of an industry where everyone is frustrated with the status quo, be they a patient, provider or payer. For the last 20 years, the technology penetration hasn’t been there. Now that it’s emerging, we see companies providing real value to their customers. There are real sustainable businesses underneath this movement.”

As Gandhi stated, it’s an inherent dissatisfaction in healthcare driving digital health’s growth; 258 digital health companies each raised more than $2 million in 2014. According to Rock Health’sreport, the top six categories for digital health funding last year (accounting for 44 percent of all digital health funding in 2014) were: Analytics and Big Data ($393M), Healthcare Consumer Engagement ($323M), Digital Medical Devices ($312M), Telemedicine ($285M), Personalized Medicine ($268M), Population Health Management ($225M).

 

Mapping out the prospective growth categories for next year is fairly straight forward; find the sources of need, and you’ll have a pretty good idea of where the growth will continue. Therefore, we asked Gandhi on his perspective of what categories will be in bloom next year.

Here are five digital health categories poised for significant growth in 2015:

1. Telehealth/Telemedicine:

Telemedicine was the fastest growing category in digital health last year, increasing 315 percent with nearly $300 million in aggregate funding, fueled by both new and established entrants. Two core issues surrounding the continued growth of telemedicine are licensure and reimbursement. According to a report from the American Telemedicine Association (ATA), 22 U.S states received an A overall rating for physician practice standards in licensure. “We are seeing a lot of positive moment there” said Gandhi.

Additional positives include ATA’s developed accreditation program for health providers who offer patient consultations, and CMS’ agreement to reimburse seven new covered services for telehealth, which began this year. Still, there are challenges in licensure that remain to stymie some of telemedicine’s potential growth next year. There are still no federal telemedicine standards in the U.S despite the more than 40 telehealth-related bills in Congress. “You can never time legislation, but the overall trend is favorable,” said Gandhi.

Reimbursement growth is a bit slower, but the uptake and adoption of telemedicine service providers by private insurance companies is a promising sign of things to come. Gandhi says he would be surprised if every exchange-based health plan didn’t have telemedicine in its network within the next few years.

“The network will be narrow and aligned to specific telemedicine providers, but it will be there,” he said. “It will be interesting to see what happens when consumers who have grown to favor certain consumer telemedicine services are denied access to those providers by their insurance providers,” he said.

2. Payer Administration & Hospital Administration

High operating pressures on razor-thin operating margins will continue to push growth in payer administration in 2015. In the face of MLR caps, cutting administration costs is essential for many payers, as billions of bills continue to be passed back and forth with gross inefficiency. “Looking at the companies we’ve seen, most payers need to cut their administrative structure by 15 to 50 percent to maintain neutral profitability under the MLR cap,” said Gandhi. “There is significant pressure now, because payers can no longer pass off those operational costs onto their customers.”

Hospital administration will continue to see growth for similar reasons, as many providers are willing to make short-term administrative gains to fund long-term IT investments that they are mandated to implement. But Gandhi says don’t expect to see a lot of growth in EHRs specifically.

“I don’t see EHRs as a growth category for funding,” he said. “However, I think what we will see is a lot of funding around clinical workflow, so everything that lives beneath, above, or around those EHRs, from the highly clinical to the more administrative-based tools.”

Although the continued libration of data from EHRs continues to drive growth in Big Data and Analytics, Gandhi thinks the EHR market itself is pretty mature. That being said, it is possible that a cycle of EHRreplacement could occur. According to a survey conducted by Rand Corporation, 61 percent said that EHRs improved quality of care, but 43 percent stated their EHR system slowed them down, and only 35 percent stated that their EHRs improved their job satisfaction.

“I think we continue to see tremendous growth surrounding EHRs for a while,” said Gandhi. “But even with the dissatisfaction rate around EHRs, I am not sure providers are going to invest in replacements, especially if they continue to invest in the solutions that work with their existing EHRs. Don’t expect to see growth there, but definitely expect to see continued growth around them as a result.”

3. Health Consumer Engagement

To be clear, the category of consumer health engagement isn’t about using an app that your doctor prescribed to engage you in your care. This category pertains to the purchasing and/or selecting of healthcare services and insurance by consumers. It’s expected to see substantial growth, especially now that consumer-directed health plans, including high-deductible health plans (HDHPs), are on the rise.

According to a survey conducted by the National Business Group on Health, large employers are projecting a 6.5 percent increase in healthcare costs in 2015. As a result, many are opting to offer consumer-directed health plans as a way to mitigate those increases. Eighty-one percent of large employers in the survey said they would offer at least one consumer-directed plan in 2015, up from 72 percent in 2014. About one-third of employers (32 percent) said consumer-directed health plans will be their only offering in 2015.

Those changes will finally crest the long-term trend of consumer engagement, now that that upwards of 30 to 40 percent of healthcare costs are coming out of consumer’s pockets, along with the mandate that you must purchase insurance or face a penalty.

“They are being forced into the market,” said Gandhi. “The nice thing about that is they are forced to realize how terrible it is. For the last five years, they have been buying things they love online with ease. For many, buying health insurance on Healthcare.gov has been one of the worst purchasing experiences they’ve ever had. Their dissatisfaction is going to push growth in multiple areas in this category from health services to purchasing processes. That’s why this category holds some of the greatest opportunities out there.”

4. Digital Therapies

Digital Therapies experienced break-out growth in 2014 that will continue to expand this year, according to Gandhi. A number of companies to emerge from this category include Omada, Propeller Health, Lantern, Wellframe, and Wildflower Health, demonstrating that you can use software to deliver clinical outcomes. Many of the companies were seed funded two to three years ago and ran effectiveness studies that are now being used to commercialize their products, which has the makings for an effective business model in the making not unlike the models of drug makers.

From mental health services to disease management interventions, digital therapies could gain a lot of traction as population health management and reimbursement shadow fee-for-service models.

“Seventy-five percent of our healthcare costs are tied to chronic diseases,” said Gandhi. “Eighty percent of heart disease and diabetes is preventable through lifestyle modification. So what we need to see, is more of the software-based programs that can modify behaviors. As these young companies iron out the business model, I think we will see a lot happen here.”

5. Personal Health Tools/Tracking

Media was abuzz last year as 2014 brought many promises for growth in the personal health tools tracking category. However, Gandhi says this category shows continued promise but the code hasn’t been cracked as to how to tap in and dominate the opportunities there just yet.

If you look at relative frame work when it comes to daily-active users vs. monthly-active users for companies like Facebook, for example, you are considered an outlier company if you are at 50 percent and successful at 30%. That lower number isn’t  going to work in healthcare, says Gandhi. “When it comes to the main three areas of wellness (diet, exercise, and sleep) to achieve success in this area, you need to see those numbers north of 40 percent.”

Despite that fact, Gandhi says the potential is what will continue to drive investment in this category. Solutions surrounding daily mental-health activities may be a possible growth area for one (similar to those emanating in the digital therapies category), along with sleep, which has also been less penetrable.

“We haven’t figured out how to create that all-essential tracking app or device just yet, which is why I think the growth will continue. There still is a very high unmet need out there,” said Gandhi.

If Gandhi’s assertions are correct, 2015 is poised be another banner year for digital health. Still, it’s hard not to wonder how many innovators will try and fail as they seek to penetrate the market. However, if hopes are as high as these investments, we stand to see a lot of gains in 2015. Digital health appears to be venture capital’s new bellwether—a fitting symbol to ringing in a new, and perhaps prosperous, New Year.

Link: http://hitconsultant.net

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Top 5 Risks of the ICD-10 Conversion

by System Administrator - Monday, 16 March 2015, 11:06 AM
 

Making a Smooth Transition: Avoiding the Top 5 Risks of the ICD-10 Conversion

As most physicians are well aware, on October 1, 2015 a significant change is set to occur in the health care industry: the adoption of the ICD-10 code set for reporting diagnoses and procedures to payers. The new code set increases the number of reporting codes from about 13,600 to more than 69,000, representing a dramatic increase in the level of reporting detail and granularity.

The increased complexity of ICD-10 will require a wide variety of adaptations by health care providers. A report by one health care strategic planning firm lists staff education and training; businessprocess analysis of health plan contracts, coverage determination, and documentation; changes to superbills; IT system changes, increased documentation costs, and cash flow disruption. The changeover to ICD-10 will also be costly for many practices. The costs for a typical small practice range from $56,639-$226,105.

This whitepaper outlines the 5 major risks of the ICD-10 transition that your practice should expect:

1. Lack of preparation by your billing, practice management, and EHR vendor
2. Lack of preparation by your payers
3. Insufficient training for your staff
4. Reduced physician and staff productivity
5. Financial risk associated with high transition costs

Are there ways to make the transition less painful and expensive?

Yes, but you can’t do it on your own. Your billing, practice management, and EHR vendor should be working hard right now, with you and with payers, to adapt your system for this changeover. In order to determine if your vendor is doing what is necessary, one source suggests that you ask the vendor these questions:

1. What is covered by vendor contracts?
2. What are vendor plans and timelines?
3. How will systems work with both ICD-9 and ICD-10 codes?
4. What does the implementation process include?
5. Is there a cost associated with training and support?

This whitepaper offers an additional six questions you should ask. The answers to these questions will help you determine if you are working with a billing, practice management, and EHR vendor that can make your transition to ICD-10 as smooth as possible, allowing you to maintain your focus on patients.

Please read the attached whitepaper.

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Topol: Challenges around data hold up the democratization of medicine

by System Administrator - Saturday, 20 June 2015, 3:01 PM
 

Dr. Eric Topol: Challenges around data hold up the democratization of medicine

By Jonah Comstock

Dr. Eric Topol’s newest book is called “The Patient Will See You Now.” At BIO during his keynote talk, a whirlwind overview of the digital health space, Topol freely acknowledged that he wasn’t the first person to riff on that phrase.

“It takes 2.6 weeks to get an appointment with a primary care doctor on average. Since it’s hard to see a doctor is, what’s really interesting in contrast is that everyone else will see you now,” he said, pointing to a slide full of recent headlines. “The crowd will see you now, the patient will see you now, Dr. Google will see you now, the robot will see you now, the avatar will see you now. Everyone will see you now. Everyone but the doctor.”

Topol was highlighting two different intersecting trends — a doctor shortage and the availability of a number of different technologies that could stand in for a doctor visit in some circumstance, whether it’s telemedicine, a tricorder-like home health scanning device, home and consumer-facing lab technologies, or new services like Pager that send doctors to the user’s home in an Uber-like business model.

“There’s five different apps where you can get a doctor to come to your house to do a consult,” he said. “One of them’s called Heal and it’s backed by Lionel Ritchie. I wrote to him and said ‘Maybe you should have called it ‘All night long’. He said ‘No, it’s all day long too’.”

He pointed to Apple ResearchKit and to the number of different digital health pilot efforts by pharma companies in recent years as evidence that sensors and connectivity are already changing the face of medicine. But in some ways, we’re not ready for those changes yet, particularly when it comes to how we handle data.

“We’re really long on capturing and hoarding data and we’re really short on processing that data. That’s a real problem,” he said. “We have to do much better. A second problem is we live in this hyper-connected world which is great, but it has a big liability we have not yet addressed: privacy and security. This is untenable in the medical world. We have to be able to preserve that.”

But perhaps the biggest data problem we’re still facing is the question of who owns medical data, Topol said.

“Patients want their data more than researchers or their doctors want to give it to them,” he said. “People want their data and they’re not getting it. Who owns the data? Interestingly enough, in the US in 49 out of 50 states the patient doesn’t own their data. Only in New Hampshire does the patient own their data. Everywhere else it’s the doctor or hospital. That has to get fixed.”

Finally, like other speakers at the event, Topol compared digital health to self-driving cars, a technology that has moved from inconceivable to seemingly inevitable in just the past few years.

“We have now seen the development of autonomous driverless cars,” he said. “In fact, they have been deemed safer than human beings driving. Who would have expected that to happen so fast? But we also have the ability to do this in medicine. Because these new tools to digitize human beings also can democratize them. We need to have co-pilots, not passengers, a new relationship in care. We have doctorless patients for a lot of the diagnostics coming, for a lot of the remote monitoring coming. But we need doctors more than ever for the treatment, the oversight of that data, the guidance, the expertise, and the wisdom.”

Tags: BIO | BIO 2015 | data access | democratization of medicine | Dr. Eric Topol | Eric Topol | patient data | Uber for Health | Uber for medicine |  

Link: http://mobihealthnews.com

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Transforming The EHR Into A Knowledge Platform

by System Administrator - Wednesday, 1 April 2015, 4:14 PM
 

Transforming The EHR Into A Knowledge Platform To Ensure Improved Health And Healthcare

The EHR Is More Than The Automation Of The Paper Chart. It Is A Knowledge Platform. This white paper focuses on the need and best practices for EHRs to be set up not only for cost-benefit success and workflow efficiency, but for their ability to inform and support the clinical process toward improved outcomes. Knowing that better clinical decisions require content that defines data, workflow and decision flow across care processes, this paper will explain how the EHR, configured correctly per care processes and integrated into the workflow, can be transformed from a data-recording repository to a proactive system for knowledge-driven care. It will also offer tips for making this happen.

Overview

Depression, anxiety, alcohol or other substance use illnesses are among the most common and disabling health conditions worldwide, according to a 2007 article published by “The Lancet.” These conditions often cooccur with chronic medical diseases that can exacerbate the behavioral or mental illness and/or substantially worsen associated health outcomes.

Consider the following example:

Todd* suffers from manic depression. Todd’s clinician informed him his condition could be treated pharmaceutically to reduce symptoms and improve quality of life. However, when the clinician went to prescribe a certain drug, he was alerted by his electronic health record system that the drug would be

rendered less effective or even dangerous when combined with another drug Todd was already taking to treat a medical condition. The clinician changed the prescription, improving care and possibly saving Todd’s life. This is called “clinical decision support,” and it is one way an EHR can add significant value to a clinician and improve the care of the consumer.

For an EHR to intelligently inform the user to improve clinical decision making, a number of requirements are necessary to deliver the ideal human-system interaction.

The digitalization of healthcare is more than just the displacement of the paper record to the computer screen. During EHR implementation, much attention is placed on inputting the same required data as in the paper world to support transactions, communication, compliance and reporting. How tasks and activities were accomplished in the world of paper-based processes can -- and must -- evolve in the electronic world. Keep in mind, a paper document is nothing more than a flat, static data collection device. The way clinicians used to work, the pen was optimized for paper. An electronic system can and will do things paper documents cannot, but end users must rethink their workflows and data requirements. Unfortunately, this basic principle is oft forgotten when faced with demands of a tight implementation timeline; the primary metric becomes speed not necessarily the quality of the system setup for clinical workflows and outcomes. That’s a mistake. 

Data is king and if the data requirements are not thoughtfully considered early on in the implementation and continuously after, decisión support capabilities will be constrained. If data is not good, the technology is meaningless.

Please read the attached whitepaper

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Transfusión de sangre, ¿qué hay en la bolsa?

by System Administrator - Thursday, 9 October 2014, 10:26 AM
 
Una conferencia que derriba mitos y propone cambios de conducta

Transfusión de sangre, ¿qué hay en la bolsa?

La transfusión es uno de los procedimientos médicos más empleados y se lo considera como el segundo en el ranking de indicaciones inadecuadas.
Fuente: IntraMed 
 
El Dr. Xavier Soler Abel nos propone una conferencia que desarticula mitos respecto de la medicina transfusional y que propone cambios concretos en la práctica profesional. La transfusión sanguínea es uno de los procedimientos más realizados en el medio hospitalario y uno de los peor indicados. Sus indicaciones, contraindicaciones, efectos adversos y las alternativas para resolver situaciones clínicas críticas se analizan con una claridad poco frecuente. Encontrará usted en esta clase una serie de argumentos científicos con alto valor de evidencia que le harán reflexionar acerca de las conductas establecidas por la tradición. Conceptos como "sangre vieja", leucorreducción, eritrocitos espiculados y desfunconalizados, comportamiento de la sangre en el shock hemorrágico y otros cambiarán su perspectiva sobre un tema fundamental. ¡No se la pierda!

Video

*IntraMed agradece al Dr. Xavier Soler Abel y al Dr. Matías Feldman que hicieron posible este valioso contenido.
 
 

Dr. Xavier Soler Abel

Llicenciat en Medicina i Cirugía per la Universitat Central de Barcelona
Metge Especialista  en Medicina Intensiva periode formatiu a l’Hospital  de la Vall De Hebron  
Creador i Coordinador Médic de la Unitat de Medicina i Cirurgia Sense Sang Centro Médico Teknon des l’any 2011
Professor del NCLEX preparatory course. Universitat Internacional de Catalunya . Cursos 2000-2001 i 2001-2002
Profesor de cursos de doctorat . Universitat Autónoma de Barcelona. Programa dels anys 1992, 1993, 1994 y 1995
President Comite cientific Jornades de Medicina Transfusional , anys 2011, 2012, 2013


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