There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers. I have discussed in other articles why patients deserve their data and the benefits derived thereof. There are no substantive arguments against this practice, and I always thought, throughout my 12 years of remotely monitoring patients with these devices, that they not only were entitled to the ...
Tech
Impersonal communication on the Internet fuels cyberbullying
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over another, typically from a roughly similarly aged peer group. The bullying could be mild such as occasional name calling and having one’s books knocked down when walking in the hallway. This does not mean the effects of the bullying were mild but comparatively speaking, this is generally not ...
Health IT and doctors: A framework for successful partnerships
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand experience of the shortcomings in the healthcare industry, and we know that it’s going to take a concerted effort to upend the system. Those of us who are able to adapt and apply new technology solutions to existing problems will undoubtedly make positive changes.Barriers to entry into entrepreneurship ...
Break out of the prison of the American health care delivery system
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost of health care is the dominant political, social, and economic issue of our time. More than one expert called for a “jailbreak.”“Jailbreak” for me meant either an obscure English reality television show or an expression applied to overriding the software limitations deliberately placed on computer systems for security ...
We need an app for credible information on vaccines
Stop what you’re doing to read this The New England Journal of Medicine perspective by Dr. Doug Diekema. It’s about vaccines, opportunities for health, and physician obligation. Written for physicians, it also speaks loudly to parents and includes a few very essential points. The whole time I read the article, my thoughts kept leaping to our imminent opportunities. Today, in 2012, we can harness the tools of social media ...
There is a patient attached to that implantable defibrillator
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going to talk about what your physician looks for when a device is interrogated. Many times this happens in silence or with few words, and some pushes of a button, when done in the office, and when done with remote patient management, is accomplished either automatically or with ...
The pitfalls of email communication with patients
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively offer their patients the option to communicate with each other through email. Unlike other professionals in the United States, doctors have generally resisted the adoption of email into their practices. But according to the WSJ article, email can result in many benefits to both the doctor and patient. ...
Why adoption of EHRs is a transformational event for physicians
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine that the introduction of electronic health records is “the largest transformational event for physicians within the last 50 years.”Fifty years is a long time and takes us back into the 1960s. Certainly, there have been plenty of changes in the practice of medicine since then. We’ve seen ...
Why EMR is a dirty word to many doctors
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and the healthcare industry.However, their origin and the ulterior motives currently driving their adoption is sowing the seeds of their failure. First, what is actually happening out there? The most recent CDC data would seem to be encouraging for EMR adoption, with EMR use (finally) passing 50%.Too bad ...
Why patients with implantable defibrillators deserve their data
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009.The objective of Measure 12/15 of Meaningful Use regulations of the HITECH act which refer to electronic health records, states that eligible professionals “provide patients with an electronic copy of their health information (including diagnostic test results, problem lists, medication ...
How a doctor uses Google to market and recruit patients
When I relocated my radiation oncology practice from Jacksonville to Tampa, Florida, I had to figure out how to compete against urologists in a market that was radically different from the one I had left. Unlike their peers in Jacksonville, Tampa urologists owned their own radiation centers, guaranteeing I wouldn’t receive referrals from them.To break the referral pattern, I updated and posted my physician profile for free on an online ...
How adopting an EHR is like treating cancer
EHRs are not ready for prime time. EHR benefits are questionable and there are documented instances where patients’ deaths were directly attributed to an EHR. EHRs are cumbersome and slow. They are unnecessarily complex and built on very old technology. The people who build EHRs have no concern for the end user and therefore EHR usability is pretty abysmal. And EHRs are expensive to buy and expensive to maintain, not ...
How changing patient workflow can make using an EMR fun
One day, about 5 years into using the electronic medical record in my practice, I came to the realization that I wasn't having fun anymore. I was sitting throughout most of every office encounter facing a computer screen, my back to the patient on the exam table across the room. The joy of face to face interaction with people, the real reason I went into medicine in the first place, had been replaced with ...
Natural language processing in EMRs can improve disease tracking
Years ago, if you were elderly, had diabetes, high blood pressure, low back pain, needed a yearly flu shot and came to see this electronic health record-enabled physician (now with the nom de plume "Disease Management Care Blog"), you would have had your diabetes, high blood pressure and low back pain reassessed, you would have been given a flu shot and, for good measure, the DMCB would have tossed in a discussion ...
New classes of devices to diet and exercise
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and chefs to plan, manage and measure their diet and exercise regimens.Obviously, most of us don’t have the time or resources to diet and exercise like celebrities do, but new technologies are closing the gap. As an introduction to some of these new platforms and methods, we describe and ...
Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process of taking a history from your patient? And how often as a patient do you have to answer those same questions each time you see a new doctor? How long does this take, given that doctors and patients both complain that there is too little time for the ...
Why the prognosis of patients is difficult
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to do more harm than good. Also, persons who have limited life expectancy may want to plan, discuss their values, and consider palliative care approaches of care in addition to care focused on living as long as possible.But can one actually predict life expectancy accurately in an individual patient? ...
Innovative technologies can markedly enhance safety
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about a decade ago. From it we learned that anywhere from 44,000 to 98,000 individuals die each year of preventable medical errors (and other sources suggest the number might even be much higher). In this continuing series of posts on disruptive and transformational technologies, there are some that ...
Google knows more about certain diseases than physicians ever will
Professor Gunter Dueck, is a calm and eloquent german mathematician who’s also the CTO of IBM Germany. He studied mathematics and philosophy and eventually turned out to be a great writer and speaker. Unfortunately he only does so in German, which is why it doesn’t make much sense to post a video of him here.In a recent talk he gave (German only), he talks about whether a connected and ...
Robotics can revolutionize the delivery of medical care
Robotics has the potential to revolutionize the delivery of healthcare. It can help extend the delivery of information, expertise and clinical care across time and geographical space barriers. Robotics offers the opportunity to enhance quality of care through extension of clinical expertise and leveraging of integrated datasets and best practices. It can be used across the continuum--from the hospital setting (e.g. OR, ER, etc.) into primary care offices and even ...
