Mappy Health Train Express

 

What word rhymes with happy? Why Mappy of course ! What social media platform gives instantaneous information,in real time as to outbreaks of infectious diseases? Mappy can track the outbreak of mosquito borne diseases, influenza outbreaks, and a multitude of other potentially harmful infectious diseases.

Mappy was the result of a ‘Challenge” by HHS for development of innovative health software. 

HHS describes it’s new application, developed by: Social Health Insights.  Early on it is tracking the outbreak of West Nile Virus

“We are Tracking Disease Trends, 140 characters at a Time !”

 

MappyHealth - Monitoring disease trends, 140 characters at a time -#NowTrending2012 Challenge from Mark Silverberg

Twitter challenge sparks innovation in tracking local health trends
New web-based app leverages Twitter for real-time early warning of disease outbreaks.

Local public health officials can use a free new Web-based application, MappyHealth , to track health concerns in real time in their communities using Twitter, the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) announced today.

MappyHealth is the winning submission of 33 applicants in a developers’ challenge, “Now Trending: #Health in My Community,” sponsored by ASPR. Health officials can use data they gain through the app to complement other health surveillance systems in identifying emerging health issues and as an early warning of possible public health emergencies in a community.

The challenge grew from a request made by local health officials to ASPR for help in developing a Web-based tool that could make social media monitoring more accessible to local health departments. Studies of the 2009 H1N1 pandemic and the Haiti cholera outbreak demonstrated that social media trends can indicate disease outbreaks earlier than conventional surveillance methods. However, many Web-based apps look back after a disease outbreak, rather than attempting to identify health trends as they emerge in real time.

This more than clever and highly usable application (web based) allows for selection of criteria by selecting criteria on the top banner, such a condition, location, and twitter trend.  A visually captivating feature is the ‘running ticker tape” display of trends in episodes such as tick-borne diseases, typhoid, tuberculosis, varicella with indications as to increases or decreases in the last 4-24 hours depending upon the magnitude of each criteria.

Social Media here performs well for quick display of important information translated from tabular chart data sets into friendly, usable and easily identifiable data sets in a graphic user interface.

Kudos to Social Health Insights, LLC

 

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Governance….is it in the Right Place?

 

There seems to be a similar problem with government and healthcare.

It comes down to governance. Congress and the executive branch seem to be inept at the least, incompetent, or at times malicious.

It is time to take back not only the United States, but healthcare as well. Our leaders despite their best attempts have failed and continue to fail.

I read a blog by a respected family physician yesterday, who has decided to leave the practice that he started almost 20 years ago. He is the type of physician who has always been an innovator, beginning with his use of EMR over 15 years ago. He is known for speaking at national meetings about the benefits of health IT long before there was an ONCHIT, or RHIOs and the ARRA and HITECH. You can read his story. He  articulates very well his consternation with his group practice which took on a life of it’s own and clearly sets his new goals with firm guidelines as to how it will operate.

Rob Lamberts MD has been a dedicated physician who has worked within a difficult system. ….he is making a healthy move for himself and his family. We cannot expect providers to operate in a health system for the betterment of their patients in a constant state of frustration which evolves into what I call a “traumatic stress disorder” We cannot expect more physicians to fall on their sword to overcome the enormity of what government has done to us all (in the name of balancing budgets, preventing fraud, proper coding, treatment paradigms and more. When I read of Dr. Lamberts decision I was ‘blown away’. He is not the type to make a compulsive move.  He has acted responsibly and given more than 90 days notice to his partners and patients, alike.

I cannot speak for Dr. Lamberts, it would be far easier to throw up one’s hands and go with the flow. He knows, he already had started a successful medical practice, investing hundreds of thousands of dollars, or more likely millions of dollars in his medical practice, adding new physicians, equipment, and facilities.  Anyone who has started a medical enterprise knows the pitfalls of taking on new associates. Contrary to popular opinion group practices can be more inefficient than small closely held or solo organizations.  Eliminating insurance will eliminate much overhead, and rightly give back that responsibility to those who buy it…the patient.  This one feature will engage and empower patients in their health care costs.

Before I digress further, let me close and stay on topic.

Good luck Rob Lamberts, M.D.  You are far from alone. I only hope that most on a new path will succeed. The next step is to leave medicine altogether, some get an MBA then become health care executives (at least they have choices then). Some will become ‘entrepreneurs”, some will become disabled, or retire early.

Health Care is much too important to allow politicians to control and make decisions which have repeatedly gone sour.  They ignore good advice, take direction from the wrong directions, from powerful self-interest groups, foundations, non profit organizations, academia, pharmacy and insurance conglomerates. 

Sometimes we wish for something and when we get it we realize what a mistake it is or was.  Perhaps now is that time to reassess what health reform should be, not what it is turning out to be.  As we step through meaningful use stage I, stage II and eventually stage III it becomes apparent how flawed PPACA has become. It was all there, but no competent people read it before it was passed by a highly partisan congress.  Each side was out for it’s own selfish motives, righteousness and truly unconcerned about the burdens and extent of PPACA.

Yes, it is time to retrieve our responsibilities as physicians to govern. Most of us were intensively trained in decision making.  As regulations increase bureaucracy increases exponentially, with increasing cost, complexity, and diminished accountability.

Numerous new forms of physicians practice have appeared, concierge practices, direct practices, and cash retainer practices.  All do away with the physician being responsible for processing insurance claims. 

The present situation evolved shortly after Medicare developed mandatory assignment with direct payment to the provider. Then it progressively became worse, fueling medical inflation.  Following the curve I expect the same will occur with Obama care….Although I want health care for all and affordability.  Obama care is wrong for our patients.

 

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Mitchell Poll Reveals that Boomers will Purchase Health Care Apps

 

How important is social media to mobile health apps?  Very, according to Mitchell Research, a national polling company based in East Lansing, Michigan. Susie Mitchell is founder of MitchellPR a consulting firm focused on helping technology deliver mobile health and wellness apps to Baby Boomers.  A 30 year journalist and public relations veteran, she has a keen understanding of the 78 million person cohort. She is president of the nationally recognized marketing research, public relations and public affairs firm Mitchell Research & Communications, Inc. writes the BoomerTech blog and a weekly blog for AARP called App of the Week.  She is co-author of the book, Growing into Grace: Adventures in Self Discovery through Writing, which assists women in finding peace with their lives as they age.

There is a lot more to purchasing a mobile health app.  Providers need to be involved, and training sessions increase the likelihood they will be used as designed. 

And price point for the app is important.  About 36% would spend $1 or $2 on a medical app and 30% would spend $3 to $10.  This is good news, for app developers, insurance providers and doctors.

A common conversation amongst Boomers is that we all want to live longer and we all want more active lives.  Ask almost any Boomer what he or she thinks about getting older and you’ll hear the proclamation, “I’m not giving into aging.”

And we often say we will go to great lengths to keep the tentacles of Father Time at bay.

Now a new study shows that a majority of Baby Boomers (those born between 1946-64) who own smart phones are willing to put their money where their mouths are and purchase health apps that help monitor and combat chronic diseases.

The takeaway

Boomers want to help manage their chronic disease care, they are willing to pay for the mobile apps to help them―but they need assistance in learning how to use the apps.  There’s an opportunity for health care providers to develop 12-step type app/disease management programs to help get this medical giant under control.

What is troubling, however, is the resistance of older Boomers to be digitally connected.  The group that needs help the most is missing out on terrific apps to help them manage chronic disease. 

Lessons learned

·Just because chronic disease apps exist doesn’t mean they are used.
·Just because someone downloads a chronic disease app doesn’t mean he or she will use it.
·There needs to be a human liaison between the app and the Boomer user.
·Once the group gets comfortable together, they are willing to share their ideas and outcomes, which will make adherence to the app more likely.
·And, once they get used to it they are very likely to share their app with friends, increasing the number of users!

Searching for support groups:  Facebook groups, Twitter lists, Google Circles are a good place to find others who are familiar with health apps. Search YouTube, there are many professional and amateur training videos available.

Doctors need to step it up and encourage Boomer patients to download and use the health care apps.  If they don’t already own a tablet, trends show they will be purchasing one soon.

In my next post we are going to discuss the ideal platform…smartphone vs. tablet and operating system, iOS vs. Android.

                 

 

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The Real Low Down on Social Media, Is it B.S.?

 

Stolen from The Gilmorr Gang

 

Well, despite my commitment and interest (prurient, perhaps) I am beginning to sense a high ‘smell factor’.

Does this apply to #hcsm as much as other venues?  I think not. Most of our content is real and applies to very interesting and important content. I mean there are some interesting pundits pundit ting constantly about reform, deficits, HIT, Medicare, ACOs, PPACA……in addition to SOPA…

Is it my civil right to Google, tweet or Facebook?  Ask my spouse….no rights without responsibility.

Please do comment here, or on G+Gary Levin or +Digital Health Space ,  Facebook me, or even G-d forbid a quick ‘tweet @glevin1 .

Waste in the American Health Care System?

 

 

According to the influential Institute of Medicine, (AP) — The U.S. health care system squanders $750 billion a year — roughly 30 cents of every medical dollar — through unneeded care, byzantine paperwork, fraud and other waste, the influential Institute of Medicine said Thursday in a report that ties directly into the presidential campaign. (As printed on the BenefitsPro website today) in an article posted by Ricardo Alonso-Zaldivar , in an article titled, “Waste Not, Heal Not.” 

The ‘nuclear option’ of $750 billion dollars does little to itemize and correctly identify needless spending. It lumps it all in one bucket, private medicine, institutional medicine, government medicine (military and/or Veterans Hospitals and outpatient (ambulatory) or in patient health care.

President Barack Obama and Republican Mitt Romney are accusing each other of trying to slash Medicare and put seniors at risk. But the counter-intuitive finding from the report is that deep cuts are possible without rationing, and a leaner system may even produce better quality.

Here are some of the quotable from the article:

"Health care in America presents a fundamental paradox, ……

"The past 50 years have seen an explosion in biomedical knowledge, dramatic innovation in therapies and surgical procedures, and management of conditions that previously were fatal ...

"Yet, American health care is falling short on basic dimensions of quality, outcomes, costs and equity," the report concluded.

If banking worked like health care, ATM transactions would take days, the report said. If home building were like health care, carpenters, electricians and plumbers would work from different blueprints and hardly talk to each other. If shopping were like health care, prices would not be posted and could vary widely within the same store, depending on who was paying.

If airline travel were like health care, individual pilots would be free to design their own preflight safety checks — or not perform one at all.

IOM panel members urged a frank discussion with the public about the value Americans are getting for their health care dollars. As a model, they cited "Choosing Wisely," a campaign launched earlier this year by nine medical societies to challenge the widespread perception that more care is better.

Politicians inflame opinion and obscure the reduction of useless health care as ‘rationing of care’, when in reality inefficient and wasteful health spending creates shortages and unintentional rationing causing many to go uninsured.

More than 18 months in the making, the report identified six major areas of waste:

Unnecessary services ($210 billion annually);

Inefficient delivery of care ($130 billion);

Excess administrative costs ($190 billion);

Inflated prices ($105 billion);

Prevention failures ($55 billion),

Fraud ($75 billion).

Adjusting for some overlap among the categories, the panel settled on an estimate of $750 billion.

The present mindset is that our health system. or lack thereof is not and major reform is necessary, which brings us to step II.  Our usual cure for a problem (i.e., to make things more efficient and  less expensive are to throw money at the problems, which includes things such as incentive payments to MDs for acquiring electronic health records, the HITECH Act which provides resources for training health IT personnel, the enormous expense of designing, planning and implementing Accountable Care Organizations, the inefficiencies of disruptive technology and disruptive reorganization. 

If one want to create more chaos and dysfunction, then do exactly what is happening now. 

Examples of wasteful care include most repeat colonoscopies within 10 years of a first such test, early imaging for most back pain, and brain scans for patients who fainted but didn't have seizures.

The problem with preventive recommendations and/or recommended testing and treatment protocols is that they are often wrong, are used for many years, and then rescinded, creating confusion and loss of trust by patients.

The expected outcomes are far from being accomplished by PPACA.  It remains to be seen if it will be affirmed by the next congress.

 

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Health Insurance–Motivated Disability Enrollment and the ACA

 

Jae Kennedy, Ph.D., and Elizabeth Blodgett, M.H.P.A.  September 5, 2012 (10.1056/NEJMp1208212)

The United States relies on employer-based health insurance to cover working-age adults and their families. As a result, Americans who are unable to engage in full-time work because of a chronic health condition must not only seek out wage replacement but also pursue alternative sources of health insurance.

We believe that HIMDE is an important driver of the unsustainable growth in enrollment in public assistance programs for people with disabilities. The Social Security Administration currently has programs — such as the Ticket to Work and Medicaid Buy-In programs — that address this problem by preserving health insurance benefits for disability-program enrollees who return to work. These programs cannot address the system wide cost and structural factors contributing to HIMDE, but certain reforms included in the Affordable Care Act (ACA) do address such factors — meaning that stabilization of federal disability programs through a reduction in HIMDE is an unacknowledged but important benefit of the ACA.

Although Medicare and Medicaid funds are not as immediately vulnerable as SSDI, and the cost of these programs is a perennial concern. Unsustainable enrollment growth in disability programs contributes to this cost because Medicare and Medicaid coverage are closely linked to receipt of SSDI and SSI: SSDI beneficiaries receive Medicare 24 months after their financial benefits start, and most new SSI beneficiaries are simultaneously deemed eligible for Medicaid coverage.

In addition to making the private insurance market more accessible, the ACA will also change the public insurance landscape for disabled workers. The law originally required all 50 states to provide Medicaid coverage for persons with incomes below 138% of the federal poverty level, but the Supreme Court has ruled that such an expansion is not mandatory.4 The effect of Medicaid expansion on HIMDE will therefore vary by state. States that currently have very low income-eligibility thresholds or do not cover childless adults will dramatically increase the number of adults eligible for Medicaid if they opt to expand their programs. Adults with potentially work-limiting disabilities residing in these states will be able to obtain Medicaid without first obtaining SSI through disability eligibility.

The current process of directing applicants to SSI and/or Medicaid for benefits creates added bureaucracy and eligibility also requires asset determination as well as prior income from Medicare employment contribution.

The system is ‘rigged’ against those who never or could not gain enough credits to be eligible for SSDI.

A Simple and Inexpensive Message

 

This inspirational quote says it all. No need for multi-million dollar studies by institutes, government agencies, nor non-profit agencies.

 

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