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General interest items edited by Janice Flahiff

Let’s help patients with the tradeoffs in medicine

Hillary Clinton Health care elderly

Hillary Clinton Health care elderly (Photo credit: Wikipedia)

 

mHealth and mobile heath technologies are all the rage these days. (See my previous post,The Future of Healthcare is Already at Your Fingertips [INFOGRAPHIC]

 

While mobile devices are useful in diagnosing and gathering information (as tracking devices), it is probably best to use them wisely and not let them distract you from all life has to offer.

 

 

 

From the 27 October 2012 article at Kevin MD.com

 

…we need to consider our own tradeoffs as researchers and practitioners when talking about health communication and engaging everyone in their own health. The tradeoff for aiming to engage people more and more is that we run the risk of overwhelming people.

Some of us are like e-Patient Dave: we want full access to all of our data, and, indeed, we should have it. But as someone living with chronic autoimmune illnesses and immersed in a never-ending data stream of self-tracking, monitoring, and constant, moment-to-moment tradeoffs, I acknowledge that I don’t always want to be engaged. I already spend plenty of time dealing with my health data, and sometimes, I would rather find a new hike to do with my kids this weekend than upload more data or peruse more graphs.

In short, let’s help people choose between the butter and the butter money in smart ways, and on their terms.

[Read the entire article here, “butter and butter money” is more or less the translation of a French saying…akin to having cake and eating it too]

Found this comment to be succinct and on target

 

carolynthomas • 20 hours ago

 

Merci bien, Prof Witteman. Despite BuzzKillerSmith’s odd comment here, it seems to me that you have hit upon a critically important link between reality and wishful thinking, between homeowners and your father-in-law contractor, between both patient and physician. (And if these tradeoffs were being as effectively addressed in day-to-day health care as BKS seems to believe, we wouldn’t have stent-happy cardiologists implanting all those unnecessary stents, would we now?)

Your quote “designing for the way people are, not the way we wish they were” seems especially appropriate in the discussion of health care and emerging technology. When I attended Stanford University’s ‘Medicine X’ conference last month, I was astounded by the number of young, tech-savvy “Quantified Self” proponents gushing over The Next Big Thing in health care technology – particularly all those self-tracking smartphone apps. (I shouldn’t have been astounded – we were in the epicentre of Silicon Valley, after all!) Completely missing was any insight from the health tech startups onstage that the demographic most likely to “need” this kind of technology (especially older users living with multiple chronic diseases) is clearly the group least likely to actually use it.[My emphasis] More on this at: “When The Elephant In The Room Has No Smartphone” – http://myheartsisters.org/2012…

So the tradeoffs in emerging health technology are, just as you are doing in both your career and in your diagnosis, to respect the fine line between what’s out there and what we need to do.

 

 

 

 

October 30, 2012 Posted by | health care | , , , , | 1 Comment

Risks and benefits of direct access to lab results

From the 5 January 2012 posting by   at KevinMD.com

Excerpt from the article

I am a big fan of DIY (do-it-yourself) healthcare, at least for the bulk relatively minor issues that plague people.  I think the days when doctors were needed to control, interpret and dole out health data and information are waning.  There are simply too many ways, primarily via the internet, to get good, reliable, easy-to-understand information about our own health.

 

The Quantified Self (QS) people who use sensors, mobile apps, and other devices to collect data on themselves may be taking it to what some would consider extreme, but I think it is the wave of the future.

Now, no one would question who “owns” the data collected in this manner, but how about data collected via a medical laboratory?  Is that somehow different and something we, the patients, should not be allowed direct access to lest we harm ourselves by misinterpretation.  Interesting question!

The issue is explored in a commentary in the December 14, 2011 issue of the Journal of the American Medical Association.***  Traber Davis Giardina, MA, MSW and Hardeep Singh MD, MPH, ask the question:  “Should patients get direct access to their laboratory test results?”  They find that it is “an answer with many questions.”…

The reason to raise this question now is that there is a proposed rule by the Department of Health and Human Services in conjunction with the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention and the Office for Civil Rights, that would allow individuals the ability to access their test results directly from the laboratory by written or electronic request. …

There are a number of reasons why direct access is a good idea:

  • Between 8 and 26% of abnormal test results, including those suspicious for cancer, are not followed up in a timely manner.  Direct access could help reduce the number of times this occurs

Self-management, particularly of chronic illness has known benefits.  Just like the QS people, many folks with chronic illness obtain and manage to self-acquired lab results every day via glucometers, home pulmonary function tests, blood pressure measurements, and so forth.  Direct access to laboratory-acquired data, one could argue is a continuation of that personal responsibility…


The arguments against direct access discussed by Giardina and Singh include the following:

  • Studies show that patients prefer their physicians contact them directly when they have abnormal test results, although the studies, published in 2005 and 2009, preceded the extraordinary use of the internet to access health information that exists today.
  • There is concern over whether patients will know what to do when they receive the results – will they make erroneous interpretations or fail to contact their docs? …..

Read the entire article here

 

***Article available online to paid subscribers only.

 For suggestions on how to get this article for free or at low cost, click here

 

January 6, 2012 Posted by | health care | , , , | Leave a comment

   

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