Tag Archives: technology

IoT = Internet of Things


Well, I learned a new acronym last week. Kinda catchy. And makes me chuckle. I’ve focused on wearables quite a bit on this site and talked about integration with the care provider’s systems. But, it seems, there is a whole world of “things” that I may have been leaving out -especially when it comes to cyber security. It’s the “Internet of Things”! And for those in healthcare IT we go even further to say IoMT – Internet of Medical Things.

The Internet of things (IoT) is the inter-networking of physical devices, vehicles (also referred to as “connected devices” and “smart devices“), buildings, and other items embedded with electronics, software, sensors, actuators, and network connectivity which enable these objects to collect and exchange data

The question, in relating it to healthcare apps, is whether this IoT keeps everything secure if only the methods and safeguards around laptops, desktops and the behind the scenes servers are secured. (My post stems from this article on the topic.) It seems that those in the know or working in healthcare IT believe that, yes, they are secure for those reasons. They also report that with the methods of monitoring their networks they can tell when something is “not behaving as intended.”

So let’s flip the situation: If that care provider’s IoT has been compromised and your device (iPhone, iPad, etc) connects to it at the provider’s office could it compromise your device?

Drilling down specifically into the vulnerabilities and security risks of IoMT devices, Beth Musumeci, vice president, cybersecurity at GE Healthcare, said the threat is significant, as connected health devices, by definition, “increase the attack surface.”

Though most health systems have made advancements on the cyber security front those small rural areas who have just been struggling to get internet at their facilities are well behind the ball of the huge health conglomerates. Another aspect is the massive numbers of IoMTs that must be addressed.

Rasu Shrestha, M.D., chief innovation officer at UPMC and executive vice president at UPMC Enterprises:

What’s more, providers are becoming increasingly dependent on Internet-based resources to facilitate patient care, Shrestha said, noting that UPMC has 105,000 connected devices to manage and support. These connected devices, which are connected to networks and the cloud, have the potential to act as a gateway to break into a hospital’s main networks

(take a look at the article here)

By 2020, 78.5 million number of people worldwide will be using home health technologies … By 2019, 87 percent of healthcare facilities will implement IoMT, up 60 percent from this year.

Cyber security, to me, seems to be a swiftly growing “next big thing” in IT. And that doesn’t apply to just the medical arena. It applies to your bank, your home internet, and the nail salon where you might connect to their internet while they paint your toenails pink.

Looks like we’ve got another topic to follow on here!


You are wearing & using health apps but is your care provider using that info?


As you know I follow the mHealth world from the perspective of the patient. Recently I read an article that gave some data on the use of mHealth apps and what the care provider is doing with it. I was genuinely surprised at the statistics. The article  (patient wearable data use) states that while 41% of Americans use the technology only 6% of the care providers were currently using the data from the patient. Working in the healthcare IT field that, as I said, was surprising. While in the field we are starting to use software allowing more patient access to patient’s information it seems we are slow to the start. Another statistic that surprised me was that 29% had no intention of using the data.

A while back, I contributed a blog post that spoke of the use of mHealth data affecting who we choose as care providers – perhaps we want to utilize care providers that are actually using our data and with whom we can see the information from our visits to take more proactive steps in managing our health. Following that train of thought does this mean that the utilization of your data (well, maybe your data) is 94% just not happening?

Another article noted that only 17 percent of consumers perceive health-related industries as being most innovative today. And that “Even in today’s modern world, people think that healthcare innovation will help physicians better treat patients most,” Keith Liu, Klick senior vice president of products and innovation said in a statement. “This suggests that, when it comes to healthcare, people still want a human connection, empathy, and other benefits that can only be obtained through the patient-physician experience.”

So we, as patients, want to see our data, often a constant effort to collect by the patient, and the care providers data and notes but we do still want that care provider to use the information in a face-to-face/human interaction and view that as an optimal care scenario.

Do you use health apps? Does your care provider use your data? And how important are the two factors – use of data and transparency of data and/or human interaction – to you?

 


An Apple a day…


…will keep the doctors informed.

So maybe you haven’t been in the hospital ever or in years or even this year (we’re only a quarter-ish into the new year)… but now you just might see how an Apple might be just what the doctor ordered.

If you are already wearing that Apple Watch and happen to make it into the patient bed at Cedars-Sinai then you can synch all your info with the hospital issued iPad and your Apple Watch. That makes for a more complete record of your health and keeps the info where it can be accessed for other care providers or, in the worst of situations, where emergency responders can see it.

Back in early 2015, we heard of the hospitals piloting Apple’s HealthKit – and the big name electronic health record providers jumped in with them. John Hopkins (specifically for epilepsy)  and Ochsner Medical Center in New Orleans have worked with Epic, an electronic health record company, to integrate with the Apple Watch. Ochsner is making the use of the Apple product line to make their innovationOschner (iO) program a stellar role model for the rest of the electronic world of healthcare. I’m, personally, impressed with their program and how they seem to be making it a part of their strategic vision not just for the company but for their patients. Check out this post from last year on Oschner’s program

Yet, in the field we are all aware of the regulations around electronic health records and those devices that work with them are one of the grey areas – one that we, in the healthcare technology field hopes will stay grey!

What have your experiences been with your Apple products and your healthcare providers?

Here is a great interview article with a patient at Cedars Sinai –  and it speaks to the market that Apple is now wading into…


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?


An App Here, An App There….


Do you use health apps in your everyday life? Who directed you to the apps you use? Your doctor? Friend? Co-worker? Well, if you got yours from the App Store or Google Play then you are in the majority. That wasn’t the case 5 years ago:

This marks a shift from the firm’s 2010 survey, when more than 65 percent of healthcare practitioners said they’d be the ones to recommend mHealth apps to their patients. Five years later, that percentage has dropped to 48 percent of physicians and 46 percent of hospitals. (link to article)

Back in the late 2000s the apps were mostly driven by the health providers such as physician practices and hospitals. They were also many that were related to specific disease states or information that was gathered from the patient at the specific hospital or physician practice. Now we are seeing a trend, one that has been growing for a couple of years, of apps targeted toward exercise and diet. You may have a Fitbit or an Apple Watch, use My Fitness Pal or other apps to track what you do, what you eat, what your pulse is and how long you exercised.

But a lot of the apps fail to satisfy the users need. They may be too complicated to use, take more effort to input information or just simply don’t do what the app advertises. For instance, I have a Fitbit and originally wanted it to track my sleep. But it is not consistent so I just can’t rely on the information. A lot of the apps that you might have on your phone, iPad or such you have to either read the label and input the information about that chocolate chip cookie or glass of almond milk that you just consumed. Some are sophisticated enough to scan the barcode of the product and take the information from there into the app.

So what has your experience been with apps for your health? Did you healthcare provider point you to helpful ones? Do you use apps that are specific to your disease state – as in the case of diabetic monitors? Or have you just seen others using these apps on Facebook and thought that might work for you?

Tell me about it!


Apple’s health app


The FDA has been adding some statements about mobile apps since the release of its report back in late March. Specifically, on 6/11/14 it released more clarification on what would fall under enforcement discretion – or those that it will leave up to other entities to enforce. According to mHealth they pretty much described Apple’s health app:

“Mobile apps that allows a user to collect, log, track and trend data such as blood glucose, blood pressure, heart rate, weight or other data from a device to eventually share with a health care provider, or upload it to an online (cloud) database, personal or electronic health record.”

So what does the Apple health app have included? Well, again according to mHealth, they have several diagnostic functions, including number of times fallen, galvanic skin response, and body heat flux. They have weight and activity related metrics – the ability to track body fat percentage, steps taken, calories burned. Then the nifty basal calories burned – those pesky calories burned while you sit and do nothing. And just in case you need it – the blood alcohol content results. Along with the expected medications functions – reminders, alerts to interactions, etc. Nutrition, sleep, and vital signs seem to be included.

What really interests me about the app is that is appears to be designed to work with other products more than as a stand-alone. That makes sense as it really isn’t a medical device and where else could it get most of the medical data if it did not interact? So in my mind this puts the app out there as more of a medical record for me. Then I circle back around to where does the data go?

If you are just waiting on this fall for the release of the app you might want to do some research beforehand and order your extra device for that blood alcohol content monitor, Breathometer (as seen on Shark Tank), or your Nike+ fuel monitors.

 

 


Wearables & Healthcare Technology


Have you tried the Google Glass yet? Wear a Fitbit? In a recent post for the Pivot Point Consulting blog, I talk about wearables, those devices that you wear which capture data as you wear them about your or your health, and how they fit into healthcare technology today. I also talk about what the future might look like with the upcoming Apple & Google innovations. What will the market look like to the consumer? What does the market and the financial feasibility look like for the companies developing the wearables? And most importantly, what do we do with all that data that is or will be collected?

Take a peek and let me know how wearables can or will affect your world!


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?


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?

 


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