Back To The Future of Social Media

 

By now you must be sick of reading about social media on the Health Train Express. However I have more reason than ever to believe social media will continue to gain ground in healthcare….Doctors love technology however are mostly late adopters. They like certainty and want others to  work out the quirks. That is how most of us were trained. Primum non nocere.  Whether this applies to social media, I cannot yet say but it appears to be going in that direction.  We saw it with HIT as electronic health records entered the user market as a consumer product rather than a techie experiment.  HIX is at that point now for hospitals.  Not many doctors or hospitals want to use a non-FDA approved drug.  So this pattern is well understood.

It has taken medicine close to 30 years to absorb practice management systems, then electronic health records for routine usage.

The pattern will be the same with social media. Social media will gain traction in general and health care, doctors and hospitals will repeat their pattern of late adoption.

In a study in Forbe’s Magazine:

“IBM Study: If You Don't Have a Social CEO, You're Going to be Less Competitive

When IBM (NYSE: IBM) conducted its study of 1709 CEOs around the world, they found only 16% of them participating in social media. But their analysis shows that the percentage will likely grow to 57% within 5 years.

Why? because CEOs are beginning to recognize that using email and the phone to get the message out isn’t sufficient anymore.

The big takeaway: That using social technologies to engage with customers, suppliers and employees will enable the organization to be more adaptive and agile.

Simply put, Physicians,  CEOs and their executives set the cultural tone for an organization. Through participation, they implicitly promote the use of social technologies.  That will make their organizations more competitive and better able to adapt to sudden market changes.

Other key findings of the study include:

CEOs are changing the nature of work by adding a powerful dose of openness, transparency and employee empowerment

Companies that outperform their peers are 30 percent more likely to identify openness – often characterized by a greater use of social media as a key enabler of collaboration and innovation

While social media is the least utilized of all customer interaction methods today, it stands to become the number two organizational engagement method within the next five years, a close second to face-to-face interactions.

More than half of CEOs (53 percent) are planning to use technology to facilitate greater partnering and collaboration with outside organizations,

CEOs regard interpersonal skills of collaboration (75 percent), communication (67 percent), creativity (61 percent) and flexibility (61 percent) as key drivers of employee success

• The trend toward greater collaboration extends beyond the corporation to external partnering relationships. Partnering is now at an all-time high. In 2008, slightly more than half of the CEOs IBM interviewed planned to partner extensively. Now, more than two-thirds intend to do so.
• CEOs are most focused on gaining insights into their customers. Seventy-three percent of CEOs are making significant investments in their organizations’ ability to draw meaningful customer insights from available data.

The IBM study shows that CEOs and the companies they manage must constantly evolve to stay competitive. Partners, suppliers, employees and customers want CEOs to communicate with them on a personal level to build trust and to help align them to the organization’s strategy. There is a lot at stake here. And if CEOs continue to hide in their Ivory Towers under the guise of some old command ands control mentality, the next chapter in their career might be written somewhere else.

You and I do not want to be left behind.”

This is becoming all ‘too true’ in the healthcare space as we are witnessing with accountable care organizations, past events with HMOs, PPOs, and the emergence of major health reform bills.

 

Technorati Tags: openness,transparency,health,social media,facebook,google plus,twitter,forbes,ceo,collaboration,ehr adoption,fda,hix,social technologies

What do Physicians Know about Incentives?

 

$20B in incentives go to waste each year, says study

Not much according to  Healthcare IT News in an article by Stephanie Bouchard, Contributing Editor.

“As the healthcare industry continues to move in the direction of using compensation incentives, a new analysis reveals that incentives as currently used are not an effective motivator for healthcare professionals and waste an estimated $20 billion in resources. “

More than 75 percent of healthcare incentives are so small or poorly publicized that providers aren't even aware of them, according to a new study that suggests more than $20 billion in incentives may be wasted annually.

 

Health Care Providers and Incentives: What Works—and What Doesn’t

“While healthcare employers are offering their doctors and nurses compensation incentives, many of those health professionals were not aware of the rewards being offered or were not able to distinguish incentive pay from base pay, ZS Associates’ researchers found. One-third of respondents who did know about the incentives did not find them motivating.

The report makes four suggestions for improving incentive efforts:

1. Increase the “at risk” component. Increase the amount of money that is truly at risk. If goals are not achieved, that will be reflected in the paycheck. That “at risk” amount needs to be greater than it commonly is currently, said Bernewitz, to get people’s attention.
2. Sustain the signal. Instead of an annual summary of incentive payouts, provide regular summaries to increase awareness.
3. Get the metrics right. Some incentive programs are so focused on metrics that the effect is to dilute the incentives, so employers should focus on a few critical outcomes and tie incentives to those, said Bernewitz.
4. Communicate. Provide clear and frequent updates so employees can keep track of their goals and how they’re doing in achieving those through the year. Also give employees a chance to be a part of the incentive program design process.”

(author)As long as the metrics for incentives are correct and credible, physicians can buy into the new model for reimbursement. A key factor is reporting more than once a year, and perhaps quarterly.  The effects of change will not be apparent immediately.

 

Technorati Tags: physician incentives,reimbursements,risks,healthcare it news

Improving modern medicine: Why social media is just what the doctor ordered

 

Alex Blau, MD, Medical Director at Doximity, is a graduate of the University of California San Francisco School of Medicine and trained in emergency medicine at Stanford Hospital and Clinics. He has been working in the emerging mobile health space since he was a senior medical student, when he founded MediBabble, an iPhone-based medical language interpretation tool now in use by more than 15,000 health care professionals. In addition, Dr. Blau has worked as a healthcare journalist, has been published in multiple journals and textbooks on emergency medicine, and has been an invited speaker at national conferences on early stage startups and innovation in

The potential is huge; but until very recently, physicians have been largely unable to take full advantage of what these connections have to offer. Specifically, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 prevents doctors from using email or text messaging, much less open platforms like Facebook or Twitter, to communicate about patient care without risk of being fined or fired.

Still, the potential for physician-focused, web-based networks is huge, and HIPAA-compliant tools and sites have indeed started to take shape and populate.

Healthcare itself has been (often rightly) criticized as slow to change. In fact, Dr. Leslie Saxon recently published an insightful article on why the Internet hasn’t yet had any real impact on how medicine is practiced.

But research has shown that as far as technology goes, doctors themselves have proven to be early adopters. Having seen the kinds of conversations that have already begun to take place, I strongly believe that the future of digital medicine will be anchored in these kinds of connections.

Think, for example, of the impact of having a rural doctor in Alaska be able to send pictures of a complicated emergency case to a former classmate now working at a stroke center in Boston — and getting real-time feedback. This is where, in my mind, social networking truly goes from entertaining to life-changing.

                

With physicians connecting in real time across specialties and beyond the traditional bounds of hospital walls, patients may soon be able to stop worrying about getting access to the right specialist.

Medicine’s brightest minds will be accessible from the remotest spots — on an airplane, at an underserved clinic, or in the thick of a disaster zone. Soon, any doctor with a mobile device will have the resources and reach to pull together a personalized, patient-specific team of experts for any given case. Sometimes, it will take as little as a question to the right expert in a sub-specialty to change the course of treatment for the better. In other instances, more lasting and meaningful collaborations might take shape.

Information itself is poised to travel differently, too. Facebook and Twitter are already showing us how effectively networked communities can transmit important data, and even bring obscure new ideas to the forefront of cultural debate.

For doctors, who have historically relied heavily on sifting through a surfeit of medical journals, this kind of hive-minding can help ensure that the most promising and thought-provoking research or techniques rise to the surface and reach a wider audience. Moreover, by posting, sharing, and commenting on articles and cases within their professional networks, physicians will become more active and engaged participants in the future of medical research and learning.

The existence of these large and overlapping communities of doctors promises to tap a goldmine of public health data. Using discussion threads about symptoms and outbreaks, the spread of infectious disease can be tracked automatically, as can the efficacy and speed of treatment plans. Complications of new therapies, previously unknown risk factors for common diseases, even entirely new disease entities may be identified from increased sharing of data that has until now lived in the filing cabinets and memories of individual physicians.

The social power of networks like Facebook and Twitter to connect, entertain, and enrich our lives is undeniable. It’s time to extend the networking paradigm to healthcare and reap an even more substantive set of rewards.

As a newcomer, Google plus and their unique video conferencing platform offers a ground breaking easy, and inexpensive video conference API (up to ten two way participants and live on air to an unlimited audience presents the opportunity for medical education.  On a one to one video hangout the opportunity to do a house call, see a patient for a post op visit, screen complaints and organize your time efficiently. Broadcast a surgical procedure on air with patient permission and some time delay with an expert physician moderator.  A prototype broadcast is available,

Live Broadcast Google Hangout Thyroidectomy

 

Technorati Tags: Alex Blau MD,Facebook,Twitter,Google plus hangouts,mhealth,hipaa

Meaningful Use Creep

 

One of the features of government is it’s inherent native ability to grow, creating a chain reaction of necessities for it’s survival.

Organizations always seem to add items piece by piece until a relatively simple idea becomes distorted.

Such now seems to be the case for meaningful use as defined by HHS for physicians to qualify for incentive payments.

GAO: Doctors should submit more data to get meaningful use money (amednews)

          

Hmm.  Isn’t GSA the outfit that went to Las Vegas ? Or was that the GAO?  Maybe they should check out their own house and stay out of Medicare’s business and healthcare decision making. There also appears to be some confusion in the details of who’s who in the debacle. Several sources used the term GAO and other used GSA. This investigator had some trouble finding the correct quotes made in the news.

The GAO has proposed new criteria for M.U. and in addition to that they propose new audits to  verify proper reporting by physicians in order to qualify for

Physicians soon could be required to submit more documentation to the Centers for Medicare & Medicaid Services to validate whether they are authorized to receive meaningful use bonuses.

Saying that the Medicare incentive program is vulnerable to making improper payments, the Government Accounting Office examined the process, called attestation, that CMS uses to validate whether physicians have met meaningful use requirements. The agency recommended that CMS examine its process for auditing the incentive program and collect more information from physicians before payments are made so they won’t have to return money to CMS.

CMS agreed that its process for verifying meaningful use eligibility could be made more efficient for the agency — and more stringent for those applying for incentive pay.

The current process, called ‘attestation’ depends upon

The Medicare incentive program is facilitated directly by CMS, and the Medicaid incentive program, like the Medicaid program, is administered at the state level. The GAO examined the eligibility and reporting requirements for the Medicare program, and the reporting and verification processes in four states that have a Medicaid incentive program up and running. As of March, 44 states had programs in place, and 40 had begun issuing incentive checks.

What needs verification

Medicaid requires additional reporting that Medicare either does not require or does not verify until after payment is made. The GAO would like to see the Medicare requirements expanded to match those of Medicaid.  One example is that to meet the requirement that data be sent electronically to an immunization registry or immunization information system, Medicaid program participants must submit the name of the registry where they sent data and whether it was sent successfully. Medicare participants are required only to attest that it was done.

CMS also agreed that it needed to evaluate its auditing process to ensure its effectiveness. Kuchler said its auditing program is being implemented and that a contract was recently awarded. It plans to start audits later in 2012.

About 10% of hospitals and 20% of professionals receiving incentive checks will be selected at random for auditing. Some also will be targeted for audits.  Kuchler said whatever CMS does with the GAO recommendations, it “is conscious of not adding unnecessarily to the burden providers face in reporting for this program and will certainly factor in the element of additional time in its determinations as we move forward.”

Among the GAO’s recommendations was for CMS to offer to collect quality measure data from Medicaid program participants on behalf of the states. But CMS rejected that recommendation, saying the states that have launched incentive programs already have portals in place and that there are no significant barriers to states collecting this information on their own.

It seems to Health Train Express and our new partner, Digital Health Space that MU reporting would be electronically be verified when the information is submitted via billing or through whatever means they propose to collect the data. If no one is going to receive the data or look at it, why report it? 

And as usual the fine print is

Physicians who received improper payments would have to return the money to CMS.

So, what else is new? 

 

Technorati Tags: gao,gsa,health train express,meaningful use,cms,digital health space,medicaid,attestation,medicare,incentives

Social Media or Search Engines……The Chicken and/or the Egg?

 

Just a short time ago physicians and scientists had primarily one readily available search engine, sponsored by the National Library of Medicine and the NIH. It was and is still called “PubMed”.  Numerous iterations developed in the past two decades to search a variety of data bases held by the NLM.  You had to be an “insider” and educated about Boolean logic and commands to optimize a search for the most meaningful answers.  Too many answers can be worse than too few.

Google ranks high for health research, but all search engines lacking.

The top four search engines all provide "rich" health and medical information, but none of them stand out as the best, according to a new study published in the Journal of Medical Internet Research.

The researchers, from the University of Missouri and China, compared the top four search engines--Google, Bing, Ask.com and Yahoo!--for usability and search validity. They noted that most people use just one search engine when conducting research on a health-related topic, and then view the websites only on the first page of the search. The researchers wondered if this was the best way to obtain information.

   

Patient online health research has been on the increase and can improve patient care, but has been known to be faulty. Online searches are also increasingly being used by patients to compare provider costs and by physicians to augment their own research.
 

Search engines themselves are the subject of scrutiny and evaluation with changing search engine algorithms. The most popular search giant Google also has a Google Scholar feature. Google’s engine has been tweaked to assess relevance instead of ‘page rank’. Page rank serves well for marketing and sales but does not serve scientific research well.

At a time when I trained the typical physician would request the medical library (librarian) to direct a search and provide a list to the physician. Today the size of medical libraries is shrinking and the staff is as well. Some of their strengths have been replaced by ‘self service’ using modern internet technology and access to library subscriptions for full text article.  This has proven to be efficient for most users.

At times physicians and patients use the same search engines, and I always want to source another reference that a patient would not have access to.  After all they reimburse me to add some value to the visit about  their illness that they would not already have access.  My own opinion is reflected aptly by this opinion,

“And while 90 percent of the physicians said that more access to online medical information and resources improved the quality of care at their organization, a fifth said that patients' online health research has "been detrimental, leading to misinformation and incorrect self-diagnosis." In fact, more than half (53 percent) of those surveyed ranked "patient misinformation" as the top barrier to good doctor-patient communication, trumped only by lack of time with patients (78 percent).”

Notably, the survey revealed that physicians get their online health information from some of the same sources as patients with search engines, such as Google and Yahoo, ranking second only to medical journals as resources used by physicians.

It’s another item to “Google”

Leveraging the advances in search engine software has been increased processing power, memory and the transition to mobile devices, such as smartphones, tablet pc, and voice recognition software, such as iPhone’s Siri.

Where is the connection (if any) between the chicken and the egg and Social and Search?

Before:    1999                                                        After:  2012

  

If you have clicked on the above links to search engines or use one of the above you quickly realize that the landing page offers much more than search with the presence of social media platforms as well as advertisements.  Search and social are a driving economic infrastructure which has become vital to health care and physicians (whether they recognize it, or not)

    

The interaction of patients and physicians may begin in social media and rapidly transition to a ‘search’.  The mergers of several internet giants include Google, YouTube, and searches can include both directions to include scientific video programs, and educational courses on YouTube.

 

Like it or not, online health information--regardless of its accuracy--likely will supplant doctors as the primary source of health information as consumers grow more eHealth savvy.

First Surgery Broadcast Live on Google Plus Hangout

 

Small print:  time delay due to  hospital and legal restriction on live broadcast.

Patient centric medicine, openness and transparency  are some of the new “buzz words” we see in social media and from health care consultants.

Many patients desire this,  asking for more information to the point where some physicians become uncomfortable being this open with a patients’ private concerns. However we are all witnessing in social media patients requesting the use of social media, be it Facebook, twitter, email, or even newer platforms such as Google.

Even I was surprised when one of my social media friends requested that her thyroidectomy be broadcast live via a Google Hangout.

Without going into great detail, the video is presented without editing, and accurately  reflects the typical technical difficulties in the operating and unexpected glitches. The surgery went very well, and for a first time amateur hangout the recording went fairly well.

I had technical support from several other social media friends, handling network connections, and also two moderators advising me and controlling cameras, and audio.

Let’s join the surgery.

This undertaking was done with the full consent of the patient and the surgeon. The primary concern was delaying the transmission of the live feed. 

We are in a ‘brave new world’ with advances in health information technology, patient centric medicine, openness and transparency.  We have left behind the ‘cloistered’ spaces of the operating rooms, and the mysteries of the hospital.

It is important for our patients to become more informed (if they wish to) about their environment, especially to reduce their apprehension about what is occurring when  they are under anesthesia

Even as an experience surgeon when I returned to the video recording, it was quite exciting to watch  as an observer.

We hope that patients will see this video, have questions and comments, and surgeons alike will see the possibilities to watch a family member have surgery,  even from the comfort of their own home.

As a point of information this event was not sponsored by Google and was the product of myself, Dan McDermott, Mike Downes and Hermine Ngnomire.

This presentation is the beginning of a work in progress.  My vision and prediction is that this type of broadcast will become routine for patients and their families when and if desired.

The technology is readily available and very inexpensive. It can be accomplished with a Laptop PC, a webcam, and Wifi and in some cases hangouts can be run on 3G or 4G cellular networks.

Hangouts such as this for home health care, post discharge for patients at home, in home health services for disabled patients and technical assistance for patients and their families with durable medical equipment. The cost savings could be enormous.

We also had several anchor news people connecting with us from FOX LA and

I expect this to open a conversation and controversy.  Let’s hear from the readers.

 

 

Technorati Tags: thyroidectomy,graves disease,google,hangout on air

HealthTrain is getting an Overhaul

 

At times there is so much information we go off the track. I am optimistic the new blog design will allow readers to move around to different posts, without following a timelines.

It’s easy to believe I have been at this blog for almost ten years, beginning in 2004. The world of blogging has evolved into social media. I do not believe blogging is dead by a long shot. It facilitates writing about topics of interest and in many cases serves as a ready made web site.

The most commonly used blog platforms seem to be WordPress and Blogger. Wordpress has the advantage of sophistication and adaptability, Blogger fits into Google’s scheme of things and is easy to use and integrate with gmail, greader, gsearch google plus and gwhizz (the last one is of my making)

Beginning with my next several posts there will be some major changes. The goal is to emphasize content. The plan is to reduce clutter and utterly irrelevant links on my pages.  As it turns out no one uses those links anymore.

Several years ago the links to other pages, and places were more important, backlinks were almost essential and readers came from other bloggers who linked to your blog in return for reciprocity. That is not the case today.

Even RSS feeds are a thing of the past, unless you are wedded to readers.

For my purposes twitter, facebook and Google plus offer much.

The new Blogger Dynamic views will allow readers to skip around and not be confined to a timeline.

Technorati Tags: blogger,wordpress,google plus hangouts,facebook,twitter,reader,dynamic views

Impact of California’s Recession on Health Care

 

It would be inappropriate to ignore the effect of further cuts in California’s budget upon health in California. He proposed cuts to hospital and nursing home funding to lower MediCal costs; a 7 percent cut in In-Home Supportive Services;

"Amazingly, a year and a half into Brown's governorship and we still hear nothing of the unemployed," Del Beccaro said. "California will continue to face chronic budget deficits because so many people remain out of work.  Of course unemployed people do not have health insurance, and even if eligible many cannot afford COBRA coverage, either. 

Unemployment also has secondary direct and indirect consequences upon health. Reduced income affects nutrition. It becomes critical that low income people are educated about nutrition and the federal SNAP (formerly called “ Food Stamps “).

Physicians do not operate in a vacuum and it is important for them to inquire about employment.

A great percentage of the population in the U.S. is obese and paradoxically malnourished.

Gov. Jerry Brown's May Revise of California Budget 2012-12

 

While reductions to public services (IHHS) are significant the overall effects on Medi-Cal could be far worse.

Unemployment continues to be a major contributing cause to reduced state income and an ever upward spiral of deficits.  Has it reached a point of no return? Would you bring a business to California

Knowing what you now know, would you open a medical practice in California? Are you considering leaving California, or just leaving medicine.?

Technorati Tags: california,bankruptcy,budget deficit,medi-california,jerry brown

Medical Tort Reform in the Nutmeg State

 

While not a complete avalanche for malpractice tort reform, the docs of the nutmeg state seem to have held off the attempt to ease restrictions on filing malpractice suits against physicians.

The Connecticut Mirror  (Hartord, CT) reports:

You don't see this every day: The speaker, majority leader and minority leader all on the losing side of a 74-69 vote in the state House of Representatives.

On a bipartisan vote, the House on Thursday gutted a bill aimed at loosening the requirements for bringing a medical malpractice lawsuit, an issue that has sharply divided health care providers and plaintiffs' attorneys.

The bill would have altered a 2005 tort reform law that requires anyone who files a medical malpractice lawsuit to submit a written opinion, called a certificate of merit, from a "similar" health care provider to the one being sued, testifying to the appearance of medical neglect.

It sailed thorugh the Senate last week, but its backers were stunned Thursday night when the House gutted the bill by rejecting a Senate amendment that effectively had become the bill. After the rejection, the House leadership shelved the bill.

Eleven Republicans -- many of them lawyers -- joined 58 Democrats in support, but 41 Republicans teamed with 33 Democrats to kill the measure after opposition on the floor led by Rep. Prasad Srinivasan, R-Glastonbury, the only physician in the General Assembly.

Rep. Prasad Srinivasan, R-Glastonbury

The measure was aimed at preventing what health care providers said were frivolous lawsuits that contributed to rising malpractice insurance costs. But critics of the requirement have said it's too restrictive. They have pointed to cases that were dismissed because the physicians who wrote the opinion letters weren't considered "similar" to the ones being sued. In one case, a court dismissed a lawsuit against an emergency physician because the certificate of merit was written by a doctor who described himself as practicing trauma surgery, even though most of his work time was spent in an emergency department.

An earlier version of the bill would have changed the requirement for the author of the certificate of merit, from requiring a "similar" health care provider to a "qualified" one. That drew opposition from health care providers, who argued that it would gut the 2005 malpractice reform measure.

The bill the Senate passed Friday would not remove the law's reference to the need for a certificate of merit from a "similar" health care provider, but it also provides another option: The letter could be written by a health care provider who the court determines has enough expertise in the type of health care at issue in the complaint that he or she could testify as an expert on the standard of care. The certificate of merit would have to include a detailed basis for the provider's belief in the evidence of medical negligence, and identify one or more breaches of the standard of care.

Legislators from both parties described the proposal as a reasonable compromise, but the Connecticut State Medical Society said it did not endorse the bill as a true compromise.

 

Technorati Tags: tort reform,connecticut,malpractice

2012 The Year of mHealth

 

Mobile Technology

REGISTER NOW: An exclusive, live webinar
May 23rd at 1pm ET/10am PT

How does mHealth improve patient access to better care?

Mobile Health, or mHealth, is a rapidly growing strategy that many healthcare professionals say can increase efficiency, cut costs, provide better customer service, and help handle tough circumstances such as a remote or incapacitated patient. mHealth consists of the use of the latest communication devices and technology to bring healthcare services to the patient. Advocates claim the applications of mHealth are numerous, aiding with: remote monitoring, behavior modification, data collection, step-by-step instruction, question and answer forums, doctor visits, and even diagnosis.
Join us as our panel will provide their expert advice and answer your questions, as we ask:

• Has the public accepted the idea of mHealth? Do they agree that a "remote" doctor consultation provides value to the patients and improves the care process?
• Does this technology interfere with the professional ethos of physicians to examine and treat individuals holistically?
• Are there privacy concerns involved in taking healthcare to the communication networks?
• What are the Telehealth, Web, and Mobile phone models, and why does the model you use suit your needs best?
• What's in the future for mHealth?

If you cannot attend the live session, please feel free to register and you will receive an email notice when the archived webinar is available on-demand.

Register now to join us and ask these experts your own questions!

Dr. Marc Mitchell, MD, MS founder and president of D-tree International, is a pediatrician and management specialist who has worked in over 40 countries in Africa, Asia, and Latin America on the design and delivery of health care services.

Alex Blau, MD, Medical Director at Doximity, is a graduate of the University of California San Francisco School of Medicine and trained in emergency medicine at Stanford Hospital and Clinics.

Herb Rogove, DO, FCCM, FACP, is President/CEO of C3O Telemedicine, which is a multispecialty virtual practice that solves the problem of quick and affordable access to specialists in Tele-ICU, Tele-Neurology/Neurocritical Care and Tele-Psychiatry.

Moderator Brian S. McGowan, PhD is a research scientist who has worked as a medical educator, mentor, accredited provider and commercial supporter.

Sign up for this exclusive webinar »

Technorati Tags: mhealth,mobile apps,telehealth,telemedicine

The Battle over Health Care

 

Now that we have “Obama Care:” we have a proposal that indicates Americans do want a major health system revision. 

If one reviews the long term evolution of how this played out in Congress, Democrats were intent on getting ‘anything’ passed for the political expediency and gain, while Republican’s cool reception seemed to be more of a “we can get a better bill”, and were reticent to pass a global sweeping law that despite it’s voluminous size missed major key points to control costs.

eJanardan Prasad Singh, and Rosemary Gibson in “ The Battle over Health Care” continue on the theme of their previous book, “Wall of Silence” which was critically acclaimed.

Each of these books are available in electronic form. I read parts of Wall of Silence and found it emotionally draining, even after 40 years of treating patients. Equanimity and imperturbability only go so far.

The battle (s) over health care is by no means over. Passage of Obamacare sets the framework from which hopefully better solutions will arise.

According to Gibson the conundrum resides in the fabric of the American economy, corporate attitudes, profit margins, durable medical device manufacturers, and an insurance industry that has a firm lock on health care.

Gibson and Singh take a broader perspective on health care reform not as a single issue but as part of the economic life of the nation. The national debate unfolded while the banking and financial system teetered on the brink of collapse. The authors trace uncanny similarities between the health care industry and the unfettered banking and financial sector. They argue that a fast-changing global economy will have profound implications for the country’s economic security and the jobs and health care benefits that come with it, and they predict that global competition will shape the future of employer-provided insurance more than the health care reform law.

The judicial review serves as an interlude or recess in the process while the Supreme Court is faced with unlocking the myriad details of the law including but not limited to the ‘individual mandate”

One could say that politics should play no role in your healthcare, however the basic underlying relationships between the free enterprise system, insurers, providers, and patients has evolved into near anarchy….thus the government steps in.

Gibson and Singh provide the stage on which we are players, however they do not propose a solution.

Technorati Tags: health care,scotus,supreme court,gibson,singh,obama Care

A New Beginning in the Digital Health Space

 

Today’s post is the first using our new and as yet unproven template design. So follow along with me and send me your comments via twitter @glevin1 or on Google Plus.

The first design is called “Flip Card”.

We’ll be departing the station with some entertainment, “World’s 25 best Health Systems. Hope you enjoy the content and the music.  Blogs should not be boring, they should be fun.

Here we go !

World’s Best Health Care

Telemedicine

 

Sadly, the United States lags behind many other nations in applying telemedicine, however with concerns about increasing cost of conventional office visits it is now becoming  more common.

In Europe SAMU or (SAMU - System of Emergency Medical  Assistance)  in France- has been in operation for many years. A similar system operates in Brazil.

Telemedicine  incorporates the use of broadband and/or satellite communication between provider-provider provider-patient and provider-provider depending upon the need.

Telemedicine is defined the use of telecommunication and information technologies in order to provide clinical health care at a distance. The term includes a wide array of functionality

Most patients and providers picture a physician at one end of a link sitting in front of a video monitor talking to a patient in a different location.  However telemedicine is much more inclusive, including the following.

Telemedicine can be broken into three main categories: store-and-forward, remote monitoring and (real-time) interactive services

Contents

• 1 Disambiguation  Telehealth, eHealth (Health 2.0) can define the use of internet.
• 2 Early precursors
• 3 Types of telemedicine
  • 3.1 Categories
  • 3.2 Emergency telemedicine
• 4 General health care delivery
  • 4.1 Benefits and uses
  • 4.2 Telenursing
  • 4.3 Telepharmacy
  • 4.4 Telerehabilitation
  • 4.5 Teletrauma
• 5 Specialist care delivery
  • 5.1 Telecardiology
  • 5.2 Telepsychiatry
  • 5.3 Teleradiology
  • 5.4 Telepathology
  • 5.5 Teledermatology
  • 5.6 Teledentistry
  • 5.7 Tele-audiology
• 6 Licensure
• 7 U.S. licensing and regulatory issues
• 8 Advanced and experimental services
  • 8.1 Telesurgery
• 9 Enabling technologies
  • 9.1 Videotelephony
  • 9.2 Health information technology

Real Telemedicine in Action, Ready for the big time

Thousands of heart patients can take advantage of new technology at two Piedmont hospitals that makes their lives much easier.

Cone Health and Forsyth Medical Center are part of a pilot program testing Carelink Express by Medtronic. Carelink allows doctors to collect information from defibrillators and pacemakers in five minutes, much faster than before.

Steven Klein, cardiac electrophysiologist at Cone Health, said hospitals used to call in technicians at all hours of the day to get information from the implant.

“Once they made the decision to do it, it would probably take 30 minutes to an hour before someone could get there to look at the information,” Klein said.

And if there’s nothing, patients can be released more quickly, saving them money, Klein said.

“The patient care is improved because they don’t have to spend so much time in the emergency room,” Klein said.

Carelink device also allows doctors to get information while the patient is at home.

The pilot program will last for another six months. If things continue to go well like they have been so far, the technology will expand to other parts of the country, Klein said.

Surveys indicate the increasing use of telemedicine in daily operations. It will undoubtedly become main-stream as reimbursement standards address the cost of this functionality. Even with the expected increase in capital investment the savings will more than offset the  expense and a documented ROI.

 

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