Patience Patients – Are e-Patients Waiting for e-Docs?

Patience Patients – Are e-Patients Waiting for e-Docs? 

From the 25 January posting at Eye on FDA

…

Patients are changing.  They are accessing medical information differently, they are storing it differently and they are consuming it more voraciously.  This access to medical information and tools means that many patients are more medically conversant and knowledgeable than the patient of just five years ago.  Medical literacy is likely on the rise.

It also changes the way physician and patient communicate.  Five years ago, I never would have considered the need for email between my physician and myself, thinking it impractical.  Today, I think a physician needs to have some portal of access for the exchange of data and information.  Here are my readings – blood pressure, blood sugar, whatever… – for the week.  The medical record will reflect information not just gathered at an exam in the office, but that gathered by my apps when I am not in the office.  And when I’m diagnosed with a new condition, I fully expect either the physician or someone in his or her office to not only prescribe some medication, but to pull out an i-Pad to steer me to some good resources, including apps.  If the condition is one where there are few treatment options and I’m expected to consider a clinical trial, the i-Pad should have a clinical trials app that lets us look at what’s available together….

Related articles

• eHealth: patients are changing, but not (yet) the Physicians (scienceintelligence.wordpress.com)
• From Pinterest and Septris to the Patient of the Future (Science Blog)
  “Are ePatients self diagnosing too much ? Too many people are not going to see their doctors on a regular basis and they need to be educated on why that is a bad idea.  No printed or interactive forum can replace a trained medical professional. The Patient of the Future Like many “self-quanters,” Smarr wears a Fitbit to count his every step, a Zeo to track his sleep patterns, and a Polar WearLink that lets him regulate his maximum heart rate during exercise. Stanford University’s Septris app …”

The Economist—and the Truth About Microwave Radiation Emitted from Wireless Technologies

 

A Critique by Scientific Experts, Physicians and Oncologists

 Excerpt from the article

In its unsigned commentary on September 3, 2011, “Worrying about Wireless”, The Economistmakes a number of technical errors and misleading statements about microwave radiation that we write to correct. The governments of more than a dozen nations have issued precautionary advice and policies about wireless devices, including restricting cellphone use by children in France, India and Israel (See Worldwide Advisories at http://www.saferphonezone.com).  The Economist would do well to consult with experts in these and other tech-savvy nations to learn the science behind these countries’ decisions so that it can provide accurate reporting on wireless safety and health matters.

The Economist states:

“Let it be said, once and for all, that no matter how powerful a radio transmitter–whether an over-the-horizon radar station or a microwave tower–radio waves simply cannot produce ionising radiation. The only possible effect they can have on human tissue is to raise its temperature slightly.” 

This is a red herring.  Of course microwave radiation is non-ionizing radiation.  It has insufficient energy to directly break chemical bonds including mutating DNA. Independent studies show that microwave radiation from cellphones can damage genetic material and disrupt DNA repair without inducing heat.  Microwave radiation from cellphones can also increase the production of damaging free radicals, which can also indirectly damage DNA. ^[1a,b,c]

In 2000 the cellphone companies T-Mobil and DeTeMobil Deutsche Telekom Mobilnet commissioned the ECOLOG report.  This report acknowledged that microwave radiation damages genes, living cells, and the immune system.   Since then, the evidence base suggesting that prolonged cellphone use can harm human health has grown substantially.  In May 2011, after a rigorous review of the evidence, the World Health Organization’s (WHO) International Agency for Research on Cancer (IARC) classified radiation emitted by wireless devices including cellphones as “possibly carcinogenic.”

In addition, scientific studies carried out in Russia in the 1950s and 1960s and corroborated by European researchers more recently show that microwave radiation affects the heart, brain and liver, as well as the production of hormones and male human and animal fertility….

Read the entire article (medium long)

Related articles

• Cellphone And Wireless Risks – Experts Criticize The Economist’s Coverage (medicalnewstoday.com)
• Mobile phones – latest alert (after-cancer.com)
• Does WiFi pose health risks? (macleans.ca)
• Cellphones and health: How Canada’s precautions compare (cbc.ca)

Five Ways mHealth Can Decrease Hospital Readmissions by David Lee Scher, MD

Five Ways mHealth Can Decrease Hospital Readmissions   by Dr. David Lee Scher

From the column…

Patients who are discharged from the hospital after a heart attack, congestive heart failure, or pneumonia have high rates of short-term readmissions. As per a provision in the Affordable Care Act, a Medicare patient with one of these diagnoses who is readmitted within 30 days for the same will trigger a denial of reimbursement for the subsequent admission.  There are many things which need to change to limit these events, though not all readmissions can be prevented, as nothing in medicine is absolute.  Identification and intensive interventions (inpatient and post-discharge) with high risk patients, better communication/care coordination, discharge processes, and patient education have been shown to produce results.  I would make a case for mHealth to become an integral part of all these components of a multi-faceted solution . here are a few ways that mHealth may be incorporated in the process:

1. The use of bioinformatics to determine the patient’s low, moderate, or high risk of readmission can be put into a hospital app to be shared among members of a multidisciplinary transitional team, which will formulate a discharge and post-discharge plan based on this data, while rounding on the patient daily….

...Click here to read the entire article

Related articles

• A Step on a Scale Helps Keep Heart Patients at Home – Hospital Readmission Rates Plummet Thanks to Innovative Program (prweb.com)
• The Quiet Health-Care Revolution (Atlantic Monthly)

  While legislators talk about “bending the cost curve,” one company serving Medicare patients has discovered how to provide better care at lower cost—with wireless scales, free transportation, regular toenail trimmings, and doctors who put the patient first.

• 5 Reasons Physicians Will Love Mobile Health (engagingthepatient.com)
• mHealth Moving Fast, Raising Hope, And Questions (jflahiff.wordpress.com)
• How hospitals can avoid readmissions (kevinmd.com)
• IMSS: Most hospitals still developing mobile policies (MobileHealth News)
• Physicians in Scotland use iPhone 4 and Skype to remotely manage lung and pleural ultrasound (iMedical Apps, Dec 2011)
• UK patients able to get health advice via free iPhone medical app, review of NHS Direct app (iMedical Apps, Dec 2011)

 

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