Health and Medical News and Resources

General interest items edited by Janice Flahiff

Patient Engagement: Overused Sound Bite or Transformative Opportunity? ‹ Reader — WordPress.com

Patient Engagement: Overused Sound Bite or Transformative Opportunity?

From the 31 March 2015 post at The C Health Blog


Criteria for Stage 3 of meaningful use of EHRs were released recently and there is lots of controversy, as would have been predicted. One set of recommendations that is raising eyebrows is around patient engagement.

The recommendations include three measures of engagement, and providers would have to report on all three of them, but successfully meet thresholds on two.

  1. Following on the Stage 2 measure of getting patients to view, download, and transmit their personal health data, the Office of the National Coordinator (ONC) has proposed an increase from five to 25 percent.
  2. The second measure requires that more than 35 percent of all patients seen by the provider or discharged from the hospital receive a secure message using the electronic health record’s (EHR) electronic messaging function or in response to a secure message sent by the patient (or the patient’s authorized representative).
  3. The third measure calls for more than 15 percent of patients to contribute patient-generated health data or data from a non-clinical setting, to the EHR.

This is all a mouthful, and it’s striking and a bit misguided from two perspectives. First, this requires health care providers to present material to or interact with patients electronically in the name of patient engagement. But it is really mostly about shoveling uninspiring material at our patients that is redolent of highly technical jargon with minimal context, with the belief that it is somehow good for patients to be engaged in this way. The intent is admirable, but the execution flawed. In addition, it is not surprising that many providers have had challenges meeting the Stage 2 requirement that five percent of patients download their medical records. It seems akin to saying that this week’s book club selection is the text for advanced graduate study of quantum mechanics — and then wondering why no one shows up for the meeting.

Some define engagement in terms of how many times consumers or patients interact with informational websites or portals. Both insurers and providers do this. Once again, there is puzzlement over why consumers would choose to spend more time on sites such as BuzzFeed, Facebook and Yahoo, rather than intently study their health benefits or review their lab tests.

At Partners HealthCare Connected Health, our first generation interest in engagement came when we saw, reproducibly, that people who interact with connected health programs have consistently better health outcomes.

cHealth Blog_patient engagement_mobilePartners HealthCare Center for Connected Health's 2010 Progress Report, Forward Currents

This brings up two salient points: The first is how finely we can measure engagement using connected health.

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July 22, 2015 Posted by | health care | , , , , , , , , , , | Leave a comment

[Reblog] Could mHealth Apps Be a Reprise of the EHR? The Need For Clinician Input

From the 14 February 2014 item at The Health Care Blog

……

“…. many app developers have little or no formal medical training and do not involve clinicians in the development process and may therefore be unaware of patient safety issues raised by inappropriate app content or functioning.”

Without the insights of seasoned real-world doctors and nurses, apps could end up with the same safety issues that are plaguing electronic health records, many of which were also developed with little regard to physician or nurse input.

In other words, just because it’s a “health” app doesn’t mean its necessarily so.

February 15, 2015 Posted by | health care | , , , , , , , | Leave a comment

[Reblog] Glass Half Empty? Half Full? Shattered?

From the 5 February 2015 post By JACK COCHRAN, MD  and CHARLES KENNEY at The Health Care Blog

Technology occupies an unusual place in health care. Some people say that electronic health records are clumsy barriers between patients and their doctors. Others suggest that technology is a kind of secret sauce.

In many places physicians and other clinicians are stymied by awkward technology. In other organizations — Kaiser Permanente included — electronic health records enable some of the finest individual and population health care ever.

This humorous equation speaks volumes about technology and health care:

NT + OO = COO

New technology + old organization = Costly old organization. In other words, technology doesn’t change an organization. Change is about leadership and culture. It is about thinking in new ways and asking new questions.

For example, rather than ask how many patients can you see, let’s ask how many patients’ problems can you solve?

Instead of asking how can we convince patients to get required prevention, let’s ask how can we create systems that significantly increase the likelihood that patients get required prevention?

Instead of asking how often should a physician see a patient to optimally monitor a condition, let’s ask what is the best way to optimally monitor a condition?

When we begin asking these kinds of questions, we see technology as a tool — not a solution by itself, but as a powerful tool we can use to deliver better individual and population care. Technology, like data, is only useful when it enables clinicians and teams to work effectively to provide the highest quality care for patients.

Read the entire post here

February 6, 2015 Posted by | health care | , , , | Leave a comment

[Journal Article] The Emergent Discipline of Health Web Science -with related links and articles

Tim Berners-Lee: The World Wide Web - Opportun...

Larger image –>http://www.flickr.com/photos/40726922@N07/4702688723

Came across this article through an online professional health community.  It describes how the Internet is changing approaches to healthcare issues.  Current evidence shows Web sites can empower professional and lay alike through informational Web pages, social media, health record annotations and linkages for exploration and analysis. However, these applications can be built on to better serve the health care related needs of all.  The Web can be better” engineered for health research, clinical research, and clinical practice. In addition, it is desirable to support consumers who utilize the Web for gathering information about health and well-being and to elucidate approaches to providing social support to both patients and caregivers. Finally, there is the motivation to improve both the effectiveness and efficiency of health care.” The paper goes on to outline channelling further efforts in these areas.

  • Social networks
  • Patient Engagement Through Citizen Science and Crowdsourcing
  • Sensors, Smart Technology and Expert Patients
  • “Big Data”, Semantic, and Other Integration Technologies
  • Rapid, Automated, Contextualized Knowledge Discovery and Application

From the full text of the article

Abstract

The transformative power of the Internet on all aspects of daily life, including health care, has been widely recognized both in the scientific literature and in public discourse. Viewed through the various lenses of diverse academic disciplines, these transformations reveal opportunities realized, the promise of future advances, and even potential problems created by the penetration of the World Wide Web for both individuals and for society at large. Discussions about the clinical and health research implications of the widespread adoption of information technologies, including the Internet, have been subsumed under the disciplinary label of Medicine 2.0. More recently, however, multi-disciplinary research has emerged that is focused on the achievement and promise of the Web itself, as it relates to healthcare issues. In this paper, we explore and interrogate the contributions of the burgeoning field of Web Science in relation to health maintenance, health care, and health policy. From this, we introduce Health Web Science as a subdiscipline of Web Science, distinct from but overlapping with Medicine 2.0. This paper builds on the presentations and subsequent interdisciplinary dialogue that developed among Web-oriented investigators present at the 2012 Medicine 2.0 Conference in Boston, Massachusetts.

Read the entire article here

Related links

The Health WebScience Lab is a multi-disciplinary research initiative between Moray College UHI, NHS Grampian, HIE OpenFinder and Sitekit Solutions Ltd based in the Highlands of Scotland committed to improving health locally, nationally and internationally.

This initiative will lead, connect and collaborate on research in the emerging discipline of WebScience and Healthcare to create communities which take responsibility for their own wellbeing and self-care. This will be achieved through the application of information and other communication technologies via the internet across a whole range of functions that affect health care thereby stimulating novel research between health care professionals, the community at large and industry.

studies ” the effects of the interaction of healthcare with the web, and of the web with healthcare” and how one can be effectively harnessed to change the other

September 6, 2013 Posted by | Biomedical Research Resources, Consumer Health, Educational Resources (Health Professionals), Health Education (General Public), Librarian Resources, Web 2.0 Assignments | , , , , , , , , , , , , | Leave a comment

Troubled Teens Could Benefit from Online Access to Health Records, Say Researchers

 

From the 22 October 2012 article at ScienceDaily

 

 Online health records could be surprisingly useful for at-risk teenagers who cycle through the juvenile justice system. A new study from the Stanford University School of Medicine and the Santa Clara Valley Medical Center found that these young people have high rates of Internet use and an unexpectedly favorable attitude toward accessing their health records online.

Teens who get in trouble with the law could particularly benefit from online health records because they generally have worse health than other adolescents — and no one keeping track of the health care they do receive. These teens’ health problems range from spotty immunization histories to chronic diseases such as asthma, sexually transmitted infections, mental illnesses and substance abuse. And not only do poverty, difficult relationships with their parents and frequent moves make it hard for them to get consistent health care, these problems also increase the chances that doctors who are treating them will not have access to their medical histories..

The teens were enthusiastic about the option, with 90 percent saying it would be useful to have their health information automatically put online so they could access it later.

“I didn’t expect this level of interest because they don’t typically think of health as something that’s part of their daily lives,” Anoshiravani said, adding that these teens engage in risky behaviors that make them seem cavalier about their health.

These teens’ need for reliable and accessible health records is made even more urgent because they often do not have family members overseeing health-related chores, such as tracking immunizations and medications, checking lab results or recording their medical history. The lack of records is a problem not just in the short term but also when these teens reach adulthood, especially for those who survived serious medical events in childhood. “They may turn 18 and not know they were born with a heart defect that was surgically repaired,” Anoshiravani said.

Contrast that situation to a typical teenager. “A parent or grandparent is going with them to the doctor and keeping their health records,” Anoshiravani said, noting that troubled teens don’t have that help. And it’s not realistic to expect these teens to keep a hard copy of their medical file. “Carrying around pieces of paper that they could lose did not make sense to them, but having a place to check this information online did make a lot of sense,” he added.

The researchers were surprised to find that the teenagers would also share online health records: The vast majority of the respondents were willing to share their records with doctors and half said they would want to share the information with their parents.

The next step, Anoshiravani said, is to implement and test online health records for at-risk teens. The biggest challenge will revolve around the issue of information-sharing, since minors’ parents are entitled to see some parts of their health records, while other types of records cannot be shared with parents without the patients’ consent….

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October 22, 2012 Posted by | Consumer Health | , , , , , , , | Leave a comment

   

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