Category Archives: Found in the world lately…

What’s in store for mHealth?


From the 2014 mHealth Summit they had 4 “take-aways” – all four were ones that we have heard before and ones that we should be listening to.

I’ll start with the easy one, in my opinion – (and their #1 on the list) – Consumer Engagement is the buzzword. I’ve been talking about this one off and on for a while. We are a culture that is becoming more informed. We have access to health information much more easily than those who have come before us. Google, WebMD, and just about any health related organization, such as providers and support sites. For me, personally, I am paying attention to more on the Breast Cancer site than before because my mom is fighting breast cancer. And we’ve talked before about access to your own health information and how we all want to see what our health record looks like and find out what did the doctor realllly say in my last visit with him/her?

The next one, in my numbering system, is that Apple’s HealthKit could be a game changer. I’m still waiting on this one. It could be the game changer – I hope it is the game changer. Basically, it could connect all those wonderful health apps to the Apple Health and keep all the nifty data there for us.

Well, that brings me to my favorite of the 4 – data analysis! Now, I hope I don’t lose my non-nerd friends on this one (as my kiddos would say). I am blessed to have just started a job with a company that provides data analytics to health providers. And, let me say, WOW, I am excited! This is the meat of it all! We have sooooooooo much information on our health, health standards, metrics for health measurement and just oodles and bunches of good stuff that can help us monitor our health as individuals and as communities! We are capturing data in mobile devices, devices worn on the body, devices used in the practice of health care, electronic health records and even in the data that our insurance company holds on us – well, except Anthem – they can’t seem to hold onto our information…. (sarcasm). This is great stuff. It is time we put it to good use!

And that leads to the last of the 4 – Care Coordination works! – Why, yes, Sherlock, it does. If my care providers know what is going on with me, my labs, my meds and my tests then I get better care – or I should expect better care. More effective care. If I make sure that my nutritionist knows that my iron levels came in low on my last blood tests that my general practitioner ordered then I get better guidance on my diet. You can see where I am going here…

So – what do you see in store for mHealth in 2015?

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Data & Big Brother in healthcare


I happened across an article on data and the Big Brother effect which included data in healthcare. I’m a bit perplexed, surprised and honestly a teeny bit worried. We know that they get data on what we watch on TV. We know that they can track trending health issues using Twitter. We know that health insurance claim information has been tracked and some allegations have been made that it has/could be used against the patient in regard to cost/deductibles and even the ability to obtain coverage. My mother has had issues with this as she has what is called a pre-existing condition in the insurance world – meaning that she had a medical condition before purchasing the insurance so they won’t pay for anything to do with continued treatment.

Now, according the article, even more data is currently being mined and applied to managing/tracking the health of populations.Honestly, I was a bit shocked as to what data they were using.

 

According to report authors Pam Dixon and Robert Gellman, these include: retailer databases, financial sector non-credit information, commercial data brokers, multichannel direct response, online surveys, catalog and phone orders, warranty card registrations, Internet sweepstakes, retailer loyalty cards, lifestyle information gathered from fitness and wellness centers, and non-profit organization member or donor lists.

 

LexisNexis is one of the largest data mining companies out there. They reportedly are using court records and housing information to assist with population health management. I am puzzled by how this information could be used for that purpose. What data or information specifically are they using?

If we start using social media data – and I have to wonder what source(s) they might be tapping for this collection – then they might find out information that isn’t shared with providers of health care – more along the line of their daily habits. Do they party/drink, go skydiving, drive cars too fast…

What are your thoughts on this subject?


Is your healthcare or provider a QUALITY provider?


Do you know the quality rating for your local hospital? Or have you just heard from friends and family how wonderful or horrible it is? Did you know that you can find out what their quality grade is? It is public information at http://www.hospitalsafetyscore.org/. I recommend that you take a look.

So if you do know or have heard from others how good or bad your local providers are how accurate do you think the quality score is versus the word of mouth information? How many of you ask a friend in the healthcare field their opinion on healthcare providers? I am in the field but I always reach out to my friends working in healthcare locally before I make decisions on where or who I bring my healthcare business to.

This recent article on the secrecy present in our healthcare systems brings up some very real points. I have seen them firsthand. We have programs, policies, and checks in place to make our healthcare delivery safer but what happens to that provider that consistently makes mistakes? Honestly, I don’t see a lot of discipline or sharing of the poor quality to the public. Usually, the discipline only takes place at the licensing level and it has to get pretty bad or shared publicly before that type of discipline happens. Of course, there are venues where this information comes out but it isn’t directed to the public.

And the author has a very good point – how about the very basic human mistakes? I have worked in healthcare since high school. I’ve made human mistakes. I’ve learned from them. It is always a scary, embarrassing situation. But, again, we are human!

Tell me your thoughts and experiences!!


Social media and healthcare


I bet you use Facebook…bet you Google for information, too. Do you Tweet? If you read my previous post about Tweeting for your health you might know that Twitter is becoming a sort of marketing and information source for healthcare. I know of many hospitals, healthcare organizations and public health organizations that use Twitter as information outlets to target specific chronic disease populations. For example, my mother, sister and I have essential tremor so I “like” the International Essential Tremor Foundation Facebook page. It provides information regularly on the disease state as well as activities that are going on.

courtesy Power DMS Suite

courtesy Power DMS Suite

 

 

This infographic (picture with information) has some interesting statistics on how healthcare is using social media today. Of interest to me, because I am also very careful with my personal Facebook page versus my public pages, is the percentage of the physicians that DO accept Facebook friend requests from their patients. Unless I was truly a friend of that physician I think that I would want to respect their privacy, and mine, by not being their FB “friend”.

So how do you use social media in your healthcare life? Are you a fan/”liker” of any hospital or health system Facebook pages? Do you follow a chronic disease group on Twitter?


Do you print or view? Information today…


Working in IT (information technology) we are always conscious of printing. We try to avoid it. It is, in our world, similar to being caught using your finger to get some icing off the wedding or birthday cake when no one is looking. (yes, Tisha humor/opinion.)

So how do you get your information? Do you print off directions from MapQuest? or do you send them via text to your smart phone? Or even have that handy navigation system in your car? What about your grocery list? Is it on paper or do you have a handy app on your smart phone or iPad? Do you read paperbacks or use a Kindle/Nook/iPad?

A recent article in HIT Consultant noted the top 20 most insightful infographics of 2012. (infographics = pictures with words and/or information.)

courtesy HealthEd Academy

courtesy HealthEd Academy

 

This particular one seems to give some good statistics on how patients are learning in our age of technology. Healthcare extender I take to mean a healthcare provider. It is interesting that the majority of information given to patients is printed. Yet, when I think about some of the meaningful use requirements, one is to provide patient education upon discharge. So they print the information. Even if they were to give you links to videos or websites they print them on paper. I haven’t seen anyone emailing info rather than printing though that doesn’t mean that it doesn’t happen.

The infographic does point out that the provider (extenders) are getting their information from technology (online) resources. I would say that the majority of those resources are available to the general public, also. Yet there is often so much information available that it is contradictory or confusing for us when we search. There are some information providers that we feel are true and correct resources such as WebMD.

So how do you get information from your healthcare provider? Do you do your own research? If yes, is it before or after you see the provider? or both?


Should psychiatric information be “hidden” or access to it restricted in our health records?


In the almost 10 years of working with electronic health records one of the major decisions to be made by a facility in the implementation process is whether the general medical staff – specifically non-psychiatric staff – should have upfront access to psychiatric health information. In my experience the answer has always been no – only track able access in emergencies.
In this recent article in FierceEMR it brings to light a great point that up front access to this information can have a definitive impact or affect on the treatment decisions in the non-psychiatric care situation.
In many cases a provider could discern psychiatric conditions from medication lists but this is not always accurate and sometimes even that portion of the medication history can also be hidden.
What is your thought? Should the information be there up front for the provider? Would it affect how the provider treats the patient in both the medical sense – good or bad – and in the interpersonal sense? Would there be a certain amount of prejudice or pre-judgement by the provider?


The new “drugs” – smartphone apps or patient engagement? or both?


In a recent post I mentioned a quote from Sherry Reynolds:

 “If  # OpenNotes was a new drug that increased patient engagement by 85%,  every doctor in the country would be prescribing it.”

Now I see an article from American Medical News talking about smartphone apps being the new drug. That really caught my attention – mostly because I am trying to use that concept in my graduate class theory paper. But back to the point…We all have kids that can’t put down the phone – the smartphone because they are texting, Facetiming, gaming, or who knows what else. I’m one of those adults that is almost as bad as my child. I am always checking Facebook, checking my WordPress for comments or likes, looking up the closest cupcake bakery, or texting one of my children or Hubby because I’ve forgotten what I was supposed to have been doing while I was doing all of that. Am I addicted to my smartphone? Nahhhh Could I go a day without it completely? Hmmmm, not so sure…..I’ve gotten close while on two cruises. But when you get to shore you can usually see who’s doing what on Facebook that you might have missed. Or even those wonderful work emails that you are truly afraid that someone messed that project up while you were gone. OOYY!!

So you can see where I am going with the familiarity of those people in the US younger than the age of say 55 – no, don’t go all ballistic on me if you are over 55! My dad only knows how to answer and call on his flip phone and my mom is becoming an iPhone guru so people are different! We rely on those smartphones. Sometimes we rely on them to the point of psychically wrong proportions -but that’s another article.

This is the key point I like about this article:

Discussions are taking place in exam rooms across the country about how a $1 app could be a viable alternative to prescribing a medication and help patients monitor their health. Some even have referred to the act of physicians recommending mobile health as “prescribing an app.”

In the traditional sense of prescribing, the phrase is not accurate, said David Collins, senior director of mHIMSS, a subsidiary of the Health Information and Management Systems Society focused on mobile health initiatives. “But in the digital wave of medicine, when it comes to mobile health, I’d say it does make sense. Patients are used to going to their doctor’s office, getting their problem solved and leaving with a prescription in their hands.”

A few things to think about with this theory, from my point of view.

1) are the patients in that group of users that will know how to get the app, download/install it and then use it? If yes, this can be quick – a business card with the name of the app and whether it is available on the Apple platform or the Android.

2)If they can get to the point of using it then do they know how to get the good stuff out of the app? With calorie counter apps it seems to be easier – you program the number of calories per day, track what you eat, see how you do. With apps that are more complicated and linked – usually via bluetooth – then there is a bit more complexity to the use of the app and the information that you get from it. Then how do you share that information at your next visit? Or even before your next visit?

3) The physician – or designated office person – would need to become a person who helped patients go thru this cycle of us. They are going to have questions when they get home. They are going to have questions when they have a weeks’ worth of data in the app and can’t see what they think they should. They will need help. Can a physician office or clinic charge for that service? (my devil’s advocate at work there.)

Overall, this is a great idea. It is moving on the right path to a nation that has been embracing a healthier lifestyle over the last 15 years. Truly, we have. There are still issues with obesity and such but there is a major trend in our population to develop and maintain healthy lifestyles.

These are some great statistics:

PATIENT MOBILE HEALTH BELIEFS

59% say mobile health has given them solutions that have replaced some doctor visits.

52% say mobile health will lower health care costs within three years.

49% think it will change the way they manage their overall health.

48% say it will improve health care quality within three years.

48% think it will change the way they manage chronic conditions.

48% say it will change the way they manage medication.

46% believe it will make their health care more convenient within three years.

PHYSICIAN MOBILE HEALTH BELIEFS

42% say mobile health will make patients too independent.

27% will encourage patients to use mobile health apps.

13% will discourage patients from using mobile health apps.

Source: “Emerging mHealth: Paths for growth,” PwC, June (pwc.com/en_GX/gx/healthcare/mhealth/assets/pwc-emerging-mhealth-full.pdf)

 

Do you think you would use an app that your physician recommended ? How much “help” would you expect to need to use it? How much interaction would you expect with the physician/office if you were to use it – more or less?

 


Is our health care connected? Or is it connected under certain conditions?


Reading an article from newly named Kaiser Permanente CEO Bernard Tyson-article was written before he attained the position 4 days ago – where Mr. Tyson talks about how connected the patients at KP are with their health records. Having worked as a consultant at KP before (and remember that little page about disclaimers up there to the right….) I think that Mr. Tyson is on the right path.

Technology is changing this paradigm and creating what we at Kaiser Permanente call connected care. This means that all the patient’s providers have access to the same health care records and information is available around the clock. Patients can access their full medical records electronically anytime, viewing all medications, lab results, office visits, and more. They even have direct access to their physicians through e-mail. Patients can connect to health information 24/7 and manage their health care when it’s convenient to them instead of having to wait for an appointment. And it is safer and more secure.

The unfortunate part is that I am not a KP member. I do not live in a KP serviced area. I do not have the connection that Mr. Tyson talks about. And somehow that is wrong – for me. Why don’t I have that same information? I don’t have  health insurance right now. So does that mean I don’t get access to my records? Is it dependent on me having insurance or having a doctor that I use – and then must I use them regularly? Where are the rules for when and what records I get to see? And how long do I have to see them? Can I look back 5 years?

I applaud KP for the work they have put into making this happen. I personally know of the blood, sweat and tears that went into where they have gotten so far. So what is holding the rest of us back? Were we waiting on an election? Shame on us? While we were waiting on that election there were insurance companies buying up hospitals and health systems. Now they have my information even if I don’t.

More to come….just thought I’d ruffle the feathers a little…shake it up some… maybe get your attention…..

🙂

 


MappyHealth – is Twitter telling us the picture of our health today?


I happened upon MappyHealth doing research for my public health class and found that it was extremely interesting. It takes tweets and analyzes them to give us a picture of our health.

For instance, this morning I am still suffering from allergies so I thought I would see what is going on in the world of acute respiratory illness (it was one of the listed tags under conditions.) Here is the graph that I saw telling me the volume of tweets. It looks like we’ve had something brewing in mid-October.

from MappyHealth

 

 

 

 

 

 

 

I even found out what has been going on in Texas over the last week.

MappyHealth

 

 

 

 

 

 

 

Even more interesting is that if you click on a graph from your search you can even get to the tweet level – showing who – by Twitter name – posted and what they posted to put them in that condition group. So here is the one for Texas for STDs! 🙂

 

 

 

 

 

 

Now what do you think of this being out there? Is it helpful or privacy invasive? Were you aware that your Tweets could get you onto MappyHealth?

My first reaction was shock when I saw that it got down to the Twitter name level. But my other voice – who often plays devil’s advocate – said that if I’m going to put something on Twitter that might put me in the category …. well, maybe I should think of that first.

Overall, do I see this as a helpful tool for public health and awareness? Maybe. I’m not too convinced of its validity in the world of true research and statistics. But it is interesting…

What do you think of it? Go try it out and tell me… you have to try it!


mHealth – mobile health but not the kind where they drive up to your house…


we’re talking cell phones here. Just having read an article on this topic – which I didn’t know “existed” opened my eyes to some of the benefits that technology provides that are a bit “in your face” or duh! that makes sense! In that group though one doesn’t think of the complications that utilizing those technologies brings about.

The first part of the article in the RecorD (mHeath in Action) talks about prenatal and neonatal care. From my understanding it is more of a triage or checkup function. I was actually surprised, though I know not why, at the percentages of the population that have cell or mobile coverage. Now I live out in the country and though we have cell phones they don’t always have coverage. So am I in that 80% regardless of the fact that when I am at home it only works 25% of the time??? And how reliable is that in the scheme of utilizing this technology as an emergency facilitator or an information source? Now one take on it has this technology being used in the facilities that lack technology typically found at health care providing facilities. So the triage and communication functions themselves are more feasible to me in this situation. A rural or third world clinic might not have sophisticated diagnostic equipment for a woman going into labor 2 months early but they may be able to call someone on that cell phone. Additionally, in those areas where care is primarily provided in the home rather than a clinic – at least the first level of care – then this makes sense as the communication tool.

In the second part of the article it talks about diabetes management. My favorite quote in the article is from Howard Steinberg, founder and CEO of dLife- “If diabetes were easy to manage,” he says, “then we wouldn’t have all of the consequences of poor control…”  Exactly, Howard!! What he is getting at that I am brave enough to say here is that if those with diabetes took better control of their lives and their disease then, well, the story might be different. Don’t get me wrong, diabetes would be my worst nightmare! I am that person that mentally probably could not deal with it – and add in my fear of needles. I’m admitting it. Having been part of a team that created a diabetes disease state management program back in 2002 & 2003 for community pharmacists to provide the services then I am excited to see this new player in the diabetes disease state management game. The advances in technology since that time astound me. And honestly, I am so happy to see them being applied to diabetes management. You can have the glucose monitoring information uploaded to a cell phone to be connected to a computer for transmission to a doctor. They even have applications for the smart phones that can actually be the manager of the diabetes – quoting the article: “Lynette Ferrara, a partner in CSC’s informatics practice. “Now there are approximately 17,000 smart phone apps available for diabetes management. About 40% are for professionals, and the rest are for consumers.” I would not have guessed those numbers to be so high! Yet the article notes that few if any are based on the prevention angle – they do the reacting/reactive management. And while all these apps are great the FDA has to weigh in on many of them – which everyone knows is often a long and arduous process. One that I am not opposed to because we are a capitalist country…opportunity doesn’t always mean quality, reliability, etc.

So what does mHealth mean for us? As consumers we have more information out there for us to read and be confused by than any other time in our life/history. They physicians have that same overload. And their pressure is even greater than our because we rely on them to make the informed, “right” decisions for our care. We’ll likely get to a point that we are at a close level in information available and our ability to handle the information available.

In the meantime, if you don’t have a smart phone (in my world I pretend everyone has a cell phone because it makes me feel happy) then is this just one more reason on the list that you should? Or are you happy with the simplicity of the “just for dialing” cell phone that you have? And if you have a smart phone what do you use it for related to your health? I use it for looking up those health conditions that I perceive I have – rosacea is a good example as I have it and just went thru a major flare up and the internet has been my friend and confuser in trying to find some way to treat it. What do you use it for?


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