Health and Medical News and Resources

General interest items edited by Janice Flahiff

Mobile Healthcare Information For All

This is one noble cause!  However, I think that education should go hand in hand with this.
It is one thing to have access to healthcare information. Another thing to understand and be able to use information.

Still, I am hoping that telecoms get on board, and give back to their communities.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

July 31, 2013 Posted by | Consumer Health, health care | , , , , , , | Leave a comment

The problem with transformative technologies in medicine

http://www.healthxchange.com.sg/healthyliving/HealthatWork/Pages/top-5-health-apps-to-download.aspx

Yesterday I reflagged an item about the  Free UMSkinCheck Mobile App.
While these self check apps are wonderful consumer and patient tools, they are not without “problems”.
This KevinMD.com post outlines health app use challenges as folks gathering data without knowing what to do with and reimbursement issues (physician consultations outside of the office).

Article ends with statement “Until our system puts more value on avoiding unnecessary treatment and keeping people well we will be stuck in this struggle between patients who want to avoid seeing the doctor and doctors who can’t afford to let patients do that.”.

The problem with transformative technologies in medicine

by (KevinMD.com post, 17 July 2012)

Eric Topol wrote a post on The Health Care Blog where he looks to a future enabled by emerging technology: “Just as the little mobile wireless devices radically transformed our day-to-day lives, so will such devices have a seismic impact on the future of health care. It’s already taking off at a pace that parallels the explosion of another unanticipated digital force — social networks….

large number, if not the majority, of ear infections are undiagnosed and clear on their own at home without intervention.  Now add to this a technology which gives us the ability to see all of those undiagnosed ear infections, and we have to muster even more willpower to resist the urge to treat them all.  This is the same problem as we have encountered with PSA testing: be careful gathering data you don’t know how to handle.

But even without considering this important objection to improved data-gathering, there is another problem which stands in the way of this type of technology: reimbursement.  It sounds great to enable people to avoid visits to the doctor’s office by having tools that previously were only accessible at an office visit.  It sounds like a very good way to save money and wasted time spent in waiting rooms with outdated magazines.  But this technology presumes that doctors will be willing to act on this information without seeing the patient in the office.  It presumes we will be willing to offer free care.  If the time I spend sifting through patient-collected data rises exponentially, the payment I get for that time cannot remain at the present level: zero.

If our goal (as it should be) is to spend less money on unnecessary care, we will get to it much faster if we somehow give proper incentive.  Our encounter-based payment system stands in the way of any progress in this area.  The only way most of us get paid is to see people and deal with problems.  This makes doctors reluctant to offer any care outside of this setting, and puts undue pressure on intervention (to justify the encounter to the payors).  Until our system puts more value on avoiding unnecessary treatment and keeping people well we will be stuck in this struggle between patients who want to avoid seeing the doctor and doctors who can’t afford to let patients do that….

What is significant about the finding cited above is that patients at least get it.  They understand the value of a having a relationship with a knowledgeable physician or similar health care provider.  In spite of, and for some, because of the plethora of health information outlets on the web people want to know that they always have access to your family doc when the chips are down.”

“Here’s what I mean…based upon some 20+ years working in health care:

From the get go…going back to Hippocrates…health and health care delivery has been about the relationships between people starting with the  physician-patient.relationship.

The most important diagnostic tool a physician has at their disposal is not a smart phone…but their ability to talk with and observe  patients verbal and non-verbal behavior.

 “Talk” is not only how physicians diagnose problems and recommend the appropriate treatments…talk is also how patients are able to engage in the health care.  Perhaps the most overlooked aspect of talk (and touch) during the medical exam is the therapeutic benefits patients derive from being able to express heart-felt fears and concerns to someone who hopefully cares.”

July 18, 2012 Posted by | Consumer Health | , , , , , | Leave a comment

Mobile Devices Were Wrecking My Health. Here’s How I Plan to Change That (One Person’s Self Diagnosis)

Person with PDA handheld device.

Person with PDA handheld device. (Photo credit: Wikipedia)

From a posting at The Health Care Blog

’m the first guy to extol the fruits of mobile technology. The flexibility and power they provide, the productivity they can enhance. But every sword has two edges (unless it’s a sabre or scimitar, but I digress).

My eyesight – stuck at the same prescription for more than a decade – began worsening again about a year ago. I noticed I was sleeping less and less well, routinely waking up unrefreshed and with a sore lower back.

Mentally, I felt foggy in a way that a shot of Peet’s Coffee or 5-Hour Energy could only temporarily cure. My once-infallible memory gave way to struggles to remember routine facts and names.

At first, I blamed other factors: parenting two young boys, crossing the big 4-oh, even a saggy mattress.

But there’s increasing evidence that being unable to put down your mobile device after work can wreak havoc on your eyesightsleeppostureability to converse, even yourbasic sense of decency.

I don’t expect the Surgeon General to start Warning that the Kindle Fire is Hazardous for One’s Health. Still, it’s clear that something so right can also be so wrong…

 

[I found these excerpts a bit startling]

39% said they wake up in the middle of the night to check e-mail (8% do it every night). When asked how their device keeps them awake at night, 47% said it made them think about work, while 36% said it wakes them with sounds at night.

elite consultants don’t just send one another emails at 1 a.m. They expect answers by 3 a.m.

June 14, 2012 Posted by | Uncategorized | , , | Leave a comment

NINIH-funded study examines use of mobile technology to improve diet and activity behavior

From the May National Institutes of Health (NIH) press release

A new study, supported in part by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, suggests that a combination of mobile technology and remote coaching holds promise in encouraging healthier eating and physical activity behavior in adults. The study focused on the best way to change multiple health behaviors.

The study results will appear Monday, May 28, in the Archives of Internal Medicine, with an accompanying commentary authored by William Riley, Ph.D., a clinical psychologist and program director for the NHLBI.

Scientists from the Northwestern University Feinberg School of Medicine, Chicago, along with colleagues from other institutions, studied 204 overweight and obese adults. Prior to enrollment, participants had a diet high in saturated fat and low in fruits and vegetables. They also engaged in little daily physical activity and had high amounts of sedentary leisure time.

Each participant was assigned to one of four groups:

  • Increase fruit and vegetable intake and increase time in moderate/vigorous physical activity
  • Increase fruit and vegetable intake and reduce time in sedentary leisure activities
  • Decrease fat intake and increase time in moderate/vigorous physical activity
  • Decrease fat intake and decrease time in sedentary leisure activities

All participants received mobile devices and were trained on entering information about their daily activities and eating patterns. Coaches studied the data received and then phoned or emailed participants to encourage and support healthy changes during the three-week study. Participants were also asked to continue to track and submit their data over a 20-week follow-up period. Financial incentives for reaching study goals during the study and continuing participation during the follow-up period were offered.

All four groups showed improvements in reaching the assigned health goals, with the most striking results occurring in the group asked to increase fruit and vegetable intake and reduce sedentary leisure activities. The researchers found after 20 weeks of follow up that this group’s average daily servings of fruits and vegetables increased from 1.2 to 2.9; their average minutes per day of sedentary leisure activity dropped from 219.2 to 125.7; and the percentage of saturated fat in their daily calories went from 12 to 9.9.

In his commentary, Riley noted that the use of mobile technology to improve cardiovascular health is worth further study of the effects on health outcomes and costs. Mobile technology offers the chance to deliver key health messages without waiting for intermittent visits with health care providers, he said.

June 4, 2012 Posted by | Consumer Health, health care | , , , | Leave a comment

mHealth Moving Fast, Raising Hope, And Questions

mhealth summit logo

mHealth Moving Fast, Raising Hope, And Questions 

From the 6 December 2011 blog item by Elsevier Global Medical News

Hopes, ideas, and hundreds of apps, are floating in the hallways during the third annual mHealth [Mobile Health] Summit***, marking the beginnings of a field that is still in its infancy and carries with it more questions than answers.

The federal government is pushing mHealth, launching programs like theHealthy Apps Challenge, which Dr. Regina Benjamin, the U.S. Surgeon General, introduced in her keynote speech. Health and Human Services Secretary Kathleen Sebelius, introduced the SmokeFreeTXT program, a text messaging service that helps teens quit smoking. Ms. Sebelius has also established theText4Health Task Force last year to look at other uses of texting in promoting healthy behavior.

“As our phones get more powerful, they are becoming our primary tools for doing everything from getting directions to deciding where to eat, Ms. Sebelius said during her keynote speech on Monday.  “And increasingly, that includes using our phones to track, manage, and improve our health.  In the iTunes store alone, there are nearly 12,000 different apps related to health – a number that will probably have gone up by the time I finish speaking.”…

…we sometimes come away from a conference, such as this week’smHealth Summit, with the feeling that the only ones making a living with mHealth are conference organizers. Maybe it was the format…That being said, however, the mHealth Summit, now in its third year, is the best conference one can attend in the US if one wants to get the global pulse on all things mHealth.

That is not to say they are no advances occurring here in the US. One of the keynote speakers, cardiologist Eric Topol, gave several live demos during his talk of the mHealth tools he is already using including stating that he has not used a stethoscope in two years, instead preferring to use mobisante’s ultrasound wand and iPhone App.  Then there was our conversation with WellDoc’s CTO who informed us that they are currently being deployed at a number of institutions and hope to have a host of CPT codes that doctors can bill against in late 2012. And there was the small start-up we spoke with who has done the hard work of first identifying what the value proposition is for all stakeholders in a community (payers, providers and consumers) and then developed an extremely compelling solution (think analytics & automated quality reporting, tied to reimbursement, tied to consumer engagement) that has a lot of promise in a market where physicians’ pay will increasingly be based on outcomes and ability to meet pre-defined quality metrics…

…Addendum:
For a slightly different take, check out the post by VC firm Psilos’ Managing Partner Lisa Suennen’s. Well worth the read.

Read the entire news item with a link to a video interview

Press releases may be found here

mHealth Summit 2011 – Videos Available


Related Resources

  • Get Mobilized! An introduction to mobile resources and tools in health sciences libraries (Medical Library Association)

    Archived 2011 online class including “lecture notes”, resources, class discussions, and related slides/videos

  • Health Apps (in Health and Medical News and Resources selected by Janice Flahiff)
    a short list of information and tracking apps derived from the above Get Mobilized class

***”The largest event of its kind, the 3rd annual mHealth Summit brings together leaders in government, the private sector, industry, academia, providers and not-for-profit organizations from across the mHealth ecosystem to advance collaboration in the use of wireless technology to improve health outcomes in the United States and abroad.”

December 7, 2011 Posted by | health care | , , , , , , , , | Leave a comment

   

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