[health-vn] Will IT change how doctors treat you in 2010? [2 articles]
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Sat Jan 16 03:33:27 EST 2010
Will IT change how doctors treat you in 2010?
Telehealth tech could allow patients to be monitored wirelessly in real time
January 4, 2010 (Computerworld) With the federal government aggressively pushing
for electronic health records (EHR), 2010 could be the year telehealth
technology finally allows doctors to monitor their patients' health wirelessly
in real time -- no matter where the patient is.
Of the billions of dollars spent on health care each year, 75% to 80% of it goes
for patients with chronic illnesses such as diabetes, heart disease, asthma and
Alzheimer's Disease, according to Dadong Wan, who leads the health innovation
program at Accenture Technology Labs.
Monitoring a patient's condition in real time and using the information to
develop a more detailed medical history could eliminate the need for some
emergency treatment or hospital re-admissions by heading off health problems early.
According to a recent report from Accenture (download PDF), the rise of
inexpensive Internet connectivity and smaller, cheaper and "smarter" health
electronics should deliver better, more efficient health care.
Wireless health monitoring
The emergence of consumer health electronics such as portable ECG devices, blood
pressure monitors or weight scales can allow the seamless capture and sharing of
patient information from home, at work or even on the road. Portable ECGs, for
instance, weigh just 3.5 ounces and allow outpatients to record electrical heart
signals and transmit the results to doctors who can monitor them for trouble
down the road. Advances in microprocessors will allow such devices to connect
wirelessly with home computers, mobile phones or even remote Internet applications.
Other technologies expected to emerge include bandages or bracelets that monitor
and transmit vital signs and patient locations as well as blood sugar monitors
that -- after taking their readings -- transmit the data to central databases.
Database-enabled tools can then alert doctors and their patients to improve
treatment of chronic illnesses.
The PiiX is a wireless cardiovascular monitoring device that looks like a Band-Aid.
In addition, patients will soon be able to carry a USB stick or other electronic
device that provides access to an online database detailing their medical
history, as well as X-rays, recent test results or prescriptions. The patients
can then make that information available to hospitals, doctors and emergency
For example, the the American Ambulance Association (AAA) announced last month
that it will back a virtual medical ID system that allows paramedics to access a
patient's health history in an emergency. The medical alert technology would
also send a text message to the patient's relatives informing them that medical
care is under way.
InvisibleBracelet.org is a Web registry that started in Oklahoma, where the
local government made it available as a health benefit for state employees. The
ambulance group plans to begin training medical crews on the use of the
bracelets later this month.
Personal health records
"I'm a big proponent of finding out as much health information as we can and
keeping on top of," said Christine Chang, a Health IT analyst with research firm
Ovum. "Personal health records are just starting to be adopted now, so not many
people know about them. But in the heat of an accident, they'll be invaluable."
In the first quarter of 2010, people in the service areas supported by
AAA-affiliated EMS providers will be able to register and maintain unlimited
access to a secure online account that holds their vital health information and
up to 10 "In Case of Emergency" contacts. The service costs $5 a year, and users
can maintain an account that's accessible by certified medics and dispatchers
When emergency care is needed, authorized EMS responders get temporary,
read-only access to the information using a HIPAA-compliant search engine. If
ambulance transport is required, medics can then generate text messages or
e-mails to the person's designated emergency contacts.
Other online EHRs that will be accessible by both patients and doctors include
the HealthVault program launched by Microsoft in beta 2007. The company removed
the beta tag in August 2009. Also, Google Health, was launched last year.
HealthVault recently partnered with Kaiser Permanente and the American Heart
Association on an accessible database of health information and some clinics are
already using the sites as a cheap alternative to deploying their own EHR systems.
Federal health care dollars
Hospitals and doctors must begin rolling out EHR systems this year or risk
losing federal reimbursement money that will be paid out next year. As part of
the American Recovery and Reinvestment Act of 2009, about $19 billion in
incentives have been earmarked for electronic health records (EHR) systems. The
Health Information Technology for Economic and Clinical Health (HITECH) Act
allows for payments of up to $64,000 to each health care operation that deploys
an EHR system and proves it's being used effectively by January 2011.
Each year after that, the reimbursements through the Office of the National
Coordinator (ONC) drop, so it behooves hospitals and physician practices to roll
out systems as quickly as possible.
Larry Leisure, managing director for Ingenix Consulting, said EHR systems will
be the driving force behind many of the wireless monitoring technologies soon to
"They create a longitudinal health record," he said. "One big benefit of EHRs is
the e-visit. Imagine a patient and doctor having an e-mail conversation with
bio-monitoring equipment transmitting data. They can have a conversation with
shared information available to both. It enables patients and physicians to have
a different relationship. Think about the cost avoidance in that."
The Alzheimer's Association recently unveiled a new Web-based application that
works with mobile devices to track people suffering from dementia who wander
off. The association's Comfort Zone service is powered by Omnilink tracking
services and is the first comprehensive location management system designed
specifically for Alzheimer's patients.
Corventis Inc., a wireless monitoring device vendor, developed a wireless
cardiovascular reader that looks a lot like a typical Band-Aid. The PiiX is
water-resistant, adheres to the skin and automatically collects and transmits
health data to a second, portable device that wirelessly sends the information
to Corventis. It can then aggregate the data for analysis or pass it along
securely to physicians or for inclusion in a personal health record.
Health data uploads
Health monitoring vendor iMetrikus offers an aggregation service called
MediCompass Connect. It is a telehealth gateway members can use to upload
biometric data from over 50 personal health monitoring devices, including
glucose monitors, insulin pumps, blood pressure monitors, digital spirometers,
pedometers and weight scales. The system transfers data via a standard phone
line or PC using a single-click connectivity hub. The data is then integrated
with health management systems, such as disease and wellness programs, EHRs,
provider practice tools and predictive modeling applications.
"Now, all of a sudden a patient is checking [their own] readings and uploading
them into their patient medical record as well as an electronic medical record,"
Leisure said. "And now the physician has a way to see if a patient is being
compliant with care instructions and can see spikes in health trending data. I
think this will lead to a more compliant patient, too."
Managed care providers such as Kaiser Permanente and Group Health Cooperative in
Washington already offer eHealth visits with physicians. The virtual
interactions are more affordable because physicians are prepaid before ever
"You'll see the benefits of [electronic medical records] in a clearer and more
measurable way in prepaid health systems than in fee-for-service systems," he said.
Electronic records help support "evidence-based medicine," which allows the
federal government to monitor how doctors treat patients based on policies and
practices derived from the systematic, scientific study of standardized
treatments. For example, it's been known for years that patients should be
prescribed aspirin after a heart attack, but there is currently no way of making
sure that happens.
Standardizing on evidence-based order systems in order to qualify for federal
money, or opening up access to personal health records on cloud computing
networks, will allow doctors and patients to make better choices for care, said
Kurt Miller, the global lead for Accenture's health management solutions practice.
"We've known for decades, or certainly [for] many years, [that] you need to be
doing certain best practices post event.... But it's interesting how often those
best practices are not followed," Miller said. "I believe that these
technologies will begin to change those behaviors without a significant
investment. It's just a matter of people doing it."
Lucas Mearian covers storage; disaster recovery and business continuity;
financial services infrastructure; health care IT for Computerworld. Follow
Lucas on Twitter @lucasmearian, send e-mail at lmearian at computerworld.com or
subscribe to Lucas's RSS feed .
Texting may lead to improved health care
Medical proceduresResearch indicates electronic messages can help patients take meds
By Newswise Comments 0
Published: January 5, 2010
From a lethal distraction for drivers to dehumanizing personal interactions,
text messaging has gotten a bum rap lately. But for doctors treating patients
with chronic diseases, text messaging can be an invaluable tool, says
pediatrician Delphine Robotham of Johns Hopkins Children’s Center.
"For better or worse, this technology is here, and sending a text to a patient’s
cell phone about an upcoming appointment or a test or simply to remind them to
take their meds is a great example of how we can harness new communication
technology for a greater good.”
Research has shown that up to half of all patients may fail to take their daily
medicine properly, with forgetting being a top reason for nonadherence. So, at
least in some cases, a text reminder may be all that a patient needs, says
Robotham, who has encouraged the use of appropriate texting among pediatricians
at Hopkins Children’s.
Several recent studies have looked at use of SMS — short message service or text
messaging — in a medical context, Robotham notes. For example, one study
involving children with diabetes showed improved blood glucose testing rates.
These children also were more likely to share their blood glucose test readings
with their doctor’s office. In another study, patients on immunosuppressive
drugs after a liver transplant had improved medicine adherence. The liver study
detected measurable clinical benefits from text-messaging: Acute liver rejection
episodes dropped dramatically as a result of better medicine adherence.
Chronic conditions that require daily medicine, such as HIV, asthma and
tuberculosis, or daily testing, such as diabetes, are great candidates for "SMS
therapy,” Robotham said.
Hopkins Children’s TB expert Dr. Sanjay Jain understands the challenges of
getting TB patients to follow months-long drug regimens.
"Texting is an even more popular mode of communication outside the United States
and especially so in developing countries, where most of the TB cases are, so I
could see this being a great new way to reach those hard-to-reach patients,”
Hopkins Children’s may soon formalize the use of this technology with teen
health expert Dr. Maria Trent, designing and hoping to launch a pilot study
using text-message reminders for patients with pelvic inflammatory disease.
Treatment involves several weeks of antibiotics and requires that all patients
come back for retesting after finishing their medicine.
Pediatric HIV expert Dr. Allison Agwu has been using texts to remind her
patients of follow-up appointments and has seen good response. She also is
preparing to launch a formal study.
The reasons behind the growing social popularity of text messaging are manifold
and complex, but Robotham and colleagues believe that SMS use in the medical
setting soon will catch up.
"Why wouldn’t it?” she said. "A patient can read a text instantly and respond
unobtrusively, it doesn’t require Internet access or picking up the phone in the
middle of class or an important meeting. Sometimes, I call patients and I get no
response, but when I text, I get a response immediately.”
Pediatric specialists and primary-care pediatricians should not overlook SMS
technology, Hopkins researchers said, but there are caveats: Texting is not a
substitute for all communication, it could be expensive, and it doesn’t always
ensure reaching a patient who may have changed her number or lost his cell phone.
"It won’t be a silver bullet but it could certainly be a nice little tool,”
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