Tag Archives: questions

Can technology help you make better health care decisions?


In previous blogs I’ve talked about using technology to improve your health, such as this one on apps. Most apps today are still focused on general health and wellness. Even though that is the case those apps can help people with chronic conditions monitor those conditions. For instance, the Fitbit can monitor your pulse/heart rate. This is great if you have a heart condition.

Now picture yourself faced with a decision, large or small, about treatment for your health decision. Do you solely rely on the doctor’s advice? Do you have a discussion with the doctor weighing the options and the pros and cons? Do you Google it? What if there were an app to help you review your issues/symptoms? What if it could help you to evaluate the risks?  I think most people would like to have that assistance – especially with the “big” decisions – surgery, cancer, etc.

Then add to it that your can possibly review your own health records (check out my blog post on OpenNotes). This can help you understand your health as a whole. There are also decision aids that help translate the medical talk – you don’t have to go to a medical terminology class now to understand those words!

“There are many health conditions where there are multiple good options for treatment, and not a clear best option,” says Angie Fagerlin, chair of the department of population health sciences at the University of Utah, a research scientist at the Salt Lake City Veterans Affairs Medical Center and president of the Society for Medical Decision Making. “Shared decision making allows patients to engage in a deliberative, communicative process with their clinicians, and be active participants in their care.”

Take a peek at the article in the Wall Street Journal’s article on getting patients to take more control of their medical decisions. 

Have you used apps or decision aids in making decisions about your healthcare?


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?

 


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!


More on patient access to clinician notes


It was exciting to see another article on the patient access to clinician notes in their medical records that served as a good followup for the article that I shared with you on October 3rd about this topic. And this one was just what I wanted to know – anybody try it yet and if so how did it work out?

The OpenNotes study (this is the technical post) results led to a post on Group Health Research Institute. They found that doctors’ fears of the impact were more than the actual time impact. One note I think that is important, and am surprised on the admission, is that there was a change

“in the way their notes addressed substance abuse, mental health issues, malignancies and obesity, a smaller minority spent more time preparing their notes, and some commented that they were improved.”

And here are some actual statistics on the study:

Of 5,391 patients who opened at least one note and returned surveys, between 77 and 87 percent reported open notes made them feel more in control of their care, with 60 to 78 percent reporting increased adherence to medications. Only 1 to 8 percent of patients reported worry, confusion, or offense; three out of five felt they should be able to add comments to their doctors’ notes; and 86 percent agreed that availability of notes would influence their choice of providers in the future.

My WOW on these numbers is the 86 percent that said it would affect their choice of provider! That is significant! It is so easy to go to the clinician, tell a short story, be asked leading questions, come out with a prescription that you don’t know what it truly does or how it will help you and then have side effects you don’t know if you are supposed to have or if you need to ask about them. This is common, folks!!

I also like that the 3 out of 5 felt they should be able to add comments to the notes! Heck yeah! I want the record to reflect my own words. Let’s all admit – what we say can be heard differently than what we meant. So confirmation of what the clinician heard is very important. Recently, with a stomach virus the physician offered me a prescription for stomach cramps – though I never complained of stomach cramps. The hospital my father was in noted that he took medication for asthma and he never has.

My question to you is are you interested in those mysterious notes that your clinician writes about you?

 


AHRQ and the health of Americans: Part 3


Here we are with post #3 on the article that I’ve been talking about this week. It is a good start into some conversations or topics I hope to continue with in the future on the blog.

In part 3 I’m kind of skipping to a question that has more relevance to the technology focus of the blog and the interview. And I must say that I am quite impressed with Clancy’s response so I’m just going to re-post it here for you!

Q: The role of social media and Web messaging continues to grow, which in turn changes the way all health practitioners must communicate with consumers. In what ways has AHRQ embraced the digital world?

We are fairly active on social media.  We have had Twitter accounts since 2009. Our main account,@AHRQNews, has almost 15,000 followers ranging from health care professionals to consumers and members of the media. Our main YouTube channel, AHRQHealthTV, has almost 700 subscribers and we have different playlists for audiences interested in patient safety and prevention, as well as both in English and Spanish.  We recently launched an AHRQ Facebook page as well (@ahrq.gov) where we communicate AHRQ’s research and tools with consumer-friendly messages.  We also feature a podcast series called Healthcare 411 on our website and it is also broadcast to about 2,000 radio stations across the country.  Achieving patient-centered care is all about getting valid, reliable information to where patients live, work and play – rather than relying only on information dispenses during a clinical encounter.  We really believe that adding these different communication tools helps us reach a wide variety of audiences where they are – and see this as a shared opportunity with our public health colleagues.

 

That is a heck of a lot of resources, general ones at least, to get a patient started on asking questions, getting information, and at the least starting their own technological path to health. OK, I’m stoked for the moment and have a lot more reading and video watching to do on this one!

So do you do any reading or have any sites that you frequent when you are looking for information? I know those in Texas have recently been concerned with West Nile virus so you may have some sites that you kept up with?

Post #1 or Post #2


AHRQ and the health of Americans: part 1


This article that came out this morning in the Public Health Newswire is just packed full of stuff to talk about with you!! I’m doing a happy dance right now!! I’m going to take it a question at a time because I have so much to comment and I want to give you time to think and respond.

The first question that they ask Carolyn Clancy, MD and director of AHRQ (Agency for Healthcare Research and Quality – I’ve mentioned them before) is :

Q: AHRQ aims to improve health care services for all Americans. What role does communication play in helping the agency achieve its goal? in which she responds “The main “currency” of health care is communication – and information.” Yes, finally!!! We are admitting that the patients exist as living speaking being that can tell you what is going on if you just TALK to them! They aren’t just lab test 010101. Clancy even points to the AHRQ campaign Questions Are the Answer campaign. It give you good points to remember when dealing with your care with a clinician. The campaign provides 10 questions that you should know to ask your clinician. (I am purposely using the word clinician here because often you don’t just see a doctor but perhaps a nurse practitioner or a physicians assistant.) It also breaks down what you should expect or be prepared for in the different phases of this care cycle – before, during and after your appointment. There is an interactive build your own questions that I just adore! It helps select questions, then helps you prioritize them and then (!!!!) it puts it into a printable format with space to write the answers and notes that you can take with you to the clinicians!

Overall, don’t let the visit intimidate you. Prepare for it. YOU are the customer. YOUR life is the one being given the focus and attention. This especially applies if you are taking a child to see a clinician. And now, due to my own circumstances I am aware, it is often an elderly parent that needs to have this same preparation for an appointment by the caregiver or family member.

 

Stay tuned for the next segment!

 


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