Tag: health IT

  • Patient centric healthcare technology, anyone?

    Carlos is not my patient. Well not yet and probably never will be. Here’s why.

    Carlos is a 35/M who complained of knee pain after playing badminton one weekend. He sought consult from their company physician who requested x-rays of his knee and was referred to an orthopedist for evaluation. Carlo is single, lives alone in his house and works as an information technologist in one company . He took a week off work because he could hardly walk and his knee in pain. He scheduled that appointment with orthopedist, hired a pedicab to fetch him in his house, bring him to the diagnostic center to have his xray taken then ferry him back to his house. He has to wait for 3 days to get the results of his xrays, then hire that pedicab again to ferry him  to and back from the diagnostic center just to get the results. Never mind the long queue for just getting the plates.

    On the appointment day he hired a pedicab again to fetch him in his house, bring him to the orthopedist clinic and back. He have to queue in line, get his priority number, sit and wait for his time to be called and examined by the orthopedists. Never mind if the call is an hour late, for some unknown reasons.  After being seen and examined, he showed his xray and lab results to the orthopedist,  “Not enough for a diagnosis” was his physicians words. So the orthopedist ordered another diagnostic, an MRI, prescribed him some pain meds and was advised follow up with MRI results.

    His knee pain unbearable, Carlos asked pedicab driver to bring him to the nearest pharmacy to buy his pain meds. He soon found out it is not available there, so he went on looking for it in other pharmacies. Only then he can get home and rest his knee.

    The whole rigodon took Carlos the whole day, while bearing the pain on his knee. Thinking about an MRI made Carlos sigh in frustration. Not only that the MRI cost so much but the idea of repeating the whole rigodon doing this diagnostic and bringing it to the orthopedists just so his knees wouldn’t be painful anymore, is just too painful than his “painful” knee. Why is it that with all this healthcare technology- EMRs, Digitalized lab results, imaging,  eased the work of  healthcare providers but not of the patients?

    Of course Carlos is a fictional character. But what he went through is a chimera of the “regular” charades most patients go through when they seek physician consult. Technology is supposedly going to ease these for him, but It hadn’t trickled down to patients yet. While most healthcare providers (institutions, physicians) benefited  from the use of technology in healthcare, many patients like Carlos do not share this sentiment.

    Join us this Saturday June 4, 2016 9:00 PM Manila time to crowdsource  a patient centric approach in easing patient burden in health processes

    Many healthcare technology innovations and movers want to solve this problem-easing out the patients burden for health processes, by efficientisizing technology on the provider side. Which in some systems worked out, eventually. I’m not a health information tech guy but like Carlos, I’m very much interested in easing out this health processes burden for patients.

    • T1. Are there any health technology innovation models that will actually lessen the “patient burden” in the healthcare processes?

    As we all know, the shift to patient centric model of healthcare system, from a provider centric system isn’t exactly a fantastic honeymoon between providers and patients. Health is definitely not easy on change. Most of us knew that patient driven health is the future of medicine and we aren’t ready to accept it yet.  Thats why there’s quite a few who are developing technologies that eases out the patient’s burden.

    • T2. What are the opportunities and challenges in a patient centric/ driven healthcare technologies?

    While Carlos story is well know to healthcare professionals (and will cringe at the thought) not a few will dismiss this as “part” of being a patient. The irony of it all that sometimes, the pain we’re giving patients going through this health process is even worse that what he or she already have from his/her medical condition. “I’m sharing this doctor because you know what’s best for me” resonates both the frustration and godly adulation patients have for their physicians.

    • T3. As a patient or patient advocate any patient centric health technology  you think (or experienced) that have eased out the patient’s burden? How?

    Carlos’ story is a story told so many times. As a physician I have my armamentarium of healthcare tech to help ease out the burden of practice, but have none to unburden my patient’s charade. This often bear much on my decision to order (or not) a diagnostic procedure, a referral, a prescription or even follow up. Patient’s rarely comply because, as a matter fact it takes more than just the patient to go though this burden. Not even us physicians. We can cry foul, or technology sucks.  But patients, they rarely have..

    So patient centric healthcare technology anyone?

    Join us this Saturday June 4, 2016 9:00 PM Manila time to crowdsource  a patient centric approach in easing patient burden in health processes!

  • Disruptions in Health: Healthcare information technology in a limited resource community

    How could information technology improve healthcare in a limited resource community? 

    This is one of the questions asked in one of the health information technology appreciation talk I gave recently.

    When care is complex, expensive, and inconvenient, many afflictions simply go untreated.

    Health information technology is a broad concept that encompasses an array of technologies to store, share, and analyze health information.  In primary care, examples of health IT include the following:

    • Clinical decision support.
    • Computerized disease registries. (e.g. Trauma registries)
    • Computerized provider order entry.(CPOE)
    • Consumer health IT applications. (e.g. wearables)
    • Electronic medical record systems (EMRs, EHRs, and PHRs).
    • Electronic prescribing.
    • Telehealth

    HIT ultimately aims to help healthcare providers provide excellent care to their patient.  HIT does this by improving point of care areas along the patient – provider flow, from the time patient goes in the hospital to the time he/she went out and up to their home. (see figure below)

    cds flow
    Conventional flow of patient /point of care in a hospital setting

    Some of these HITs (EMR, CPOE)  have been shown to reduce medical errors by up to 80%, prescription errors by up to 55%. While HIT has the potential to reduce utilization of healthcare, investing in HIT is not cheap so far. The main challenges are investing cost and resources.

    The real hope is in disruptive innovations in health that uses these information technologies to bring down healthcare cost but improve quality of care.

    Disruptive innovation, a term of art coined by Clayton Christensen, describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors. – See more at: http://www.claytonchristensen.com/key-concepts/#sthash.iNDhe9BG.dpuf

    Areas like telemedicine and consumer health products are just beginning to pick up trend. But cost and quality of care metrics has yet to be validated to yield a significant disruption.

    Information technology that has potential in improving quality of care
    Information technology that has potential in improving quality of care

    So going back to the question earlier, I’m a believer that somehow a disruptive innovation would breakthrough with these sets of HIT and  improve delivery of healthcare in low resource communities.

    I’m inviting all health stakeholders- MDs, Nurses, allied med professions, policy makers, health institutions, research groups, pharma and medical devices to a tweetchat this Saturday May 14, 2016 9PM Manila time.

    Lets crowdsource ideas from HIT thought leaders and healthcare community what would these potential disruptions and innovations that will impact low resource communities.

    • T1. What health information technology you use now to provide quality care and why?
    • T2. What specific disruptive information technology do you think would improve delivery of care at a lower cost  in limited resource community (like PH)? How?
    • T3. What is the main challenge to this disruptive technology? Research? Policy?Education?

    Don’t forget to use #HealthXPh. Se you all!

    Readings:

    https://www.healthit.gov/patients-families/basics-health-it

    https://hbr.org/2000/09/will-disruptive-innovations-cure-health-care

    Disruptive Innovations That Will Change Your Life in Health Care

    http://www.forbes.com/sites/ashoka/2013/04/23/disruptive-innovation-a-prescription-for-better-health-care/#f7dfd447c442

    http://mobihealthnews.com/31470/revisiting-how-christensens-disruption-innovation-in-healthcare-means-decentralization

  • January 4, 2014 #HealthXPh Hangout on Air Launching- Your most relevant emerging technology in healthcare

    On Saturday January 4, 2014 10:00 AM Philippine Standard Time, #HealthXPh will be formally launched live on Google+ Hangout on Air (HOA). Core collaborators discussed the framework for #HealthXPh  in the last Hangout on Air. In summary;

    HealthXPh is a platform for healthcare stakeholders – physicians, patients, healthcare institutions, academe and policy makers, to discuss emerging technologies in health as it impacts the Philippine health landscape.

    #HealthXPh Hangout on Air will be a regular Saturday event for the HealthXPh community. #HealthXPh’s format is basically similar to #HCLDR chats, thanks to our colleagues Lisa Fields (@PracticalWisdom) and Colin Hung (@Colin_Hung) at Healthcare Leadership Blog.  Topics and a corresponding speaker or panel of speakers will be assigned to each hangout sessions.  Each hangout sessions will also have a preassigned moderator.

    Participants are encouraged to join the discussions and will be given time to speak or ask questions during interactive sessions. Questions maybe entertained thru Google chat ( which is just beside your Google+ hangout window) twitter using hashtag #HealthXPh or tru our FB group and FB page during the live session.

    The topics for this Saturday’s HOA are:

    • T1 Panel: What is #HealthXPh from the core collaborators?
    • T2 Open Mike: What emerging technologies do you find important and relevant in healthcare?
    • T3 Open Mike: What do you think are the obstacles to the use of emerging technologies in healthcare?
    • Closing Thought (CT): What’s one thing you’ve learned in todays discussion that you can take to your place of influence to help a patient or colleague tomorrow?

    Dr. Remo-tito Aguilar will be the moderator for this HOA.

    Here’s some very good articles you can get ideas for discussion along the Philippine healthcare context.

    1. Let’s start a grassroots physician social media movement. Wes Fisher MD. on KevinMD.com
    2. Seven Effective Ways to Engage on Twitter (shared by @endocrine_witch)
    3. 7 Social media blunders to avoid in 2014 (shared by @cebumd @endocrine_witch)

    Photo Credit to Aaron Guiterman at www.ddadvocacy.com

  • What is #HealthXPh?

    #HealthXPh is a  collaborative effort  by healthcare stakeholders (e.g. healthcare professionals, healthcare institutions, academe patients, policy makers)  to discuss and use, emerging technologies in social media and healthcare to positively impact the Philippine health landscape.

    How will you change healthcare tru social media?
    How will you change healthcare tru social media?

    While social media has been in the Philippines for quite sometime, collaboration between various healthcare stakeholders is a new thing for most of us. The following statements are what #HealthXPh could be.

      • It’s a collaborative effort of healthcare stakeholders- healthcare professionals, institutions, academe, patients and policy makers.
      • It will discuss, use and continually push the boundaries of social media and other emerging technologies in healthcare to impact the Philippine health landscape.
      • It aims to educate all the healthcare stakeholders.
      • It encourages collaboration and application of emerging technologies to improve delivery of  healthcare.
      • It is open and free to all the stakeholders.
      • Social media is going to impact Philippine healthcare. #HealthXPh want to make it a positive one.
      • Social media opens new possibilities to participatory medicine practice in the Philippines. #HealthXPh is taking advantage of that.
      • Social media and other emerging technology is making it easier for patients to access their healthcare professionals, institutions and policy makers. #HealthXPh will give insights on how to effectively manage this upsurge.

    What is not #HealthXPh?

      • It will not be a clinic online.
      • It will not replace the doctor-patients interactions inside a clinic.
      • It will not treat patients.
      • It will not pass judgement or bias on any healthcare issue but will maintain a healthy, lively discussions to educate.
      • It will not undermine authority, nor attack stakeholders to promote issues.
      • It will not jeopardize the doctor-patient privileges.

    These statements are still proposals and are subject to the discussions on #HealthXPh community. I highly encourage healthcare stakeholders  to participate in the discussions at #HealthXPh on Google Plus. We will be live online on Google Hangout starting this January 2014. An introductory Google Hang Out on Air for core panelist will happen on December 28, 2013 Saturday 10 AM.

    (Photo credits to@amanda_lyons at www.visualsforchange.com )

  • Should I get an iphone or an itouch?

    I’ve been a gadgeek (gadget freak) during Nokia and Palm OS heydays and frankly, I ‘m happy getting over such expensive gadgetry addiction years ago. But when I lost two cellphones in one instant just recently, I was tempted to dwell back at gadgetry once again while  thinking what smartphone to buy for personal use. Losing two cellular phones in one instant is like being hit in the head by a baseball bat twice in one swing. But looking at it as a hell yeah! opportunity for diving into gadgetry (again) is courting an idiopathic gadgiosyncrasy. Another bad habit to break. I think.

    Anyhow, the answer to my title-question dawned on me during one meeting with senior colleagues . They were discussing iPhone apps, in their daily life and practice.  While I love getting “cobbs angle” in x-rays of scoliosis patients using the reliable, old goniometer-pencil method,  I feel like crap when someone else comes forward and aims his/her iphone at the x-ray plates to get the cobbs angle in less than a minute.

    “There’s an iPhone app for that sir”. I felt the age (technology) gap was on me. Yes, my old method will do the same thing, but at such speed and efficiency? I have to get one of those iOS frill.

    which one would you get?

    The iPhone and the iTouch both run on the same iOS so the basic difference is just the cellphone capabilities of iPhones. If you need constant net connection then you need an iPhone. Iphones  connect to your cellular network’s paid internet service for as long you have your network signal and even without a wifi conneciton. Itouch needs a wifi signal to connect to the net. The rest of these gadgets’ features (camera,HD etc) is basically the same. Most apps for iPhones works for iTouch too except those that need  a cellular signal to work, like the GPS inherent on iPhones.

    I  don’t want my cellular phone mixed up with my iOS gadget. Iphones is such a hot stuff for kleptomaniacs in my area I might just lose it. Besides, I’m not comfortable using my cellular network’s expensive internet service. Most of the places I’m into have free wifi hotspots. So an itouch would really suffice. For now.

    How about you? Whats your preference?

    (Update July, 1, 2011: I now have both, an i touch and an Iphone. Now I’m finding use for both.)