#Google #Glasses in the hospital: A “mixture of intrigue and skepticism. #HIT #EMR

google glasses

Giuseppe Costantino photo

When it comes to health information technology — a term that encompasses everything from medical records to monitors — John Halamka — the chief information officer at  of Beth Israel Deaconess Medical Center — is the man. Here he reports on wearable computing in the hospital.

Here’s what we’ve learned thus far:
halamkaPatients have been intrigued by Google Glass, but no one has expressed a concern about them. Boston is home to many techies and a few patients asked detailed questions about the technology. The bright orange pair of Glass we have been testing is as subtle as a neon hunter’s vest, so it was hard to miss.
Staff members have definitely noticed them and responded with a mixture of intrigue and skepticism. Those who tried them on briefly did seem impressed. More from Halamka on his own blog Life as a Healthcare CIO.
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Data, health, news contest draws applications from Bostonians

How to get most of the city’s health writers in the same room as a bunch of app developers? A health-themed meet-up of the local Hacks and Hackers group might do it. But last week, a good number of us gathered a WBUR for a presentation on the Knight News Challenge. (WBUR has won in the past for a court-related project.)  The media innovation project has drawn 650 entries,  including one based on  BHN’s ongoing HealthDecider project.  The handful of winners gets money and support for a project designed to answer the following question: How can we harness data and information for the health of communities?

May the best projects win.  Here’s mine.

Here are some others from Boston or with a big local footprint.  Great ideas and stiff competition. (WBUR has its own list with lots of overlap.)

Unlocking the Potential of Patient Blogs To create the first searchable repository of health blogs, giving patients a chance to connect to others with similar medical problems and better understand what it’s like to live with their health issues.

Big Data to Big Story leverages academic medicine’s foremost health-record data-mining tool to allow the public to gain critical, previously unavailable answers about medical treatments and their outcomes.

Gimme My DAM Data This crowdsourced web site will assign a letter grade to each hospital or app privacy policy, thereby encouraging data holders to participate in the health data commons. (This on links to one of Ross Martin’s health policy music videos from The American College of Medical Informatimusicology

Increasing Patient Buy-In to a Statewide Health Data Sharing Effort We will educate consumers about the benefits of sharing their personal medical information in the statewide data-sharing network while also informing them of their rights and gathering input about their concerns, which we will share with decisionmakers at the Massachusetts Executive Office of Health and Human Services to lead to an improved data-sharing system.

Data to Table: A Healthy Recipe for Urban Agriculture The Data to Table website will visualize the details of Boston’s new rezoning ordinance for urban farming, making the information transparent and accessible for those interested in fostering healthy communities through local agriculture.

 Nothing to Hide: Tracking patient harm and hospital efforts to prevent errors We aim to help consumers wisely choose the safest hospitals by building a website that tracks incidents of patient harm at Massachusetts hospitals

 HealthNewsReview.org & Crowdsourcing: We will improve the public dialogue about health care by providing patients and health care consumers a proven platform for telling media messengers what they’re doing well, and where they’re missing the mark with the health care news and information they deliver. 


What is the # for that? See the Healthcare Hashtag Project #health #boston

hashtags 2More wisdom from #ahcj13.

Check out the “Healthcare Hashtag Project.” 

Web 2.0 and health 2.0 are converging to become one of the most powerful shifts in health and human behavior in the last generation.  At its heart is the fact that patients are people, and that people are social.  They want to know their healthcare professional, and want to both seek the opinions of others and share their own opinion, actively seeking information and optioions.  In this context patients are rightfully taking ownership of their healthcare decisions via act

ns on the web. As we looked at this rapidly evolving new landscape we found a fractured market in terms of being able to meet the varied needs of healthcare professionals and broader healthcare community who are wishing to actively enter the online sphere.  With such a dynamic and digital environment, the need for technology solutions, strategic solutions, and solutions for content creation abound.  However, with such a diverse set of issues that each require specialized talent and technical know-how, we saw a profound need to simplify the process, to decrease the barriers to entry, and to enhance the ability of healthcare entities to effectively engage and spread their message


The high ways of medical #marijuana: Not to be confused with the Massachusetts medical information highway #HIT #EMR

This funny post from BIDMC health info chief John Halamka:

The Massachusetts Health Information Highway is abbreviated the MassHIway. Its phone number is 1-800-MassHIway.
Unrelated to IT (or so we thought), Massachusetts legalized medical marijuana. This is an actual transcript of a call we received today

Sean – “Hello, Mass HIway – how may I help you?”

Caller – “Yes, can you tell me how I become a marijuana grower/dispenser?”medical pot portrait

But, seriously folks, HIT is in the news. Dr. Halamka is testifying in DC before the HIT advisory panel. If you don’t know what the term “meaningful use” is, it might be a bit too wonky for you.

And, the Globe reports, behind its paywall, that Westboro-based eClinical Works is expanding into the “patient engagement” business. Here’s the press release.  The high-way caller needs to check out this Globe story, also behind the paywall: New Mexico marijuana program a guide for Mass. Strict model may help Bay State shape its rules

For some reporting on the downside of HIT, check out the Center for Public Integrity investigation. They suggest the rise of electronic medical records has led to a jump in upcoding — threatening any savings that promise to come with HIT.

The series documented that thousands of medical professionals steadily billed Medicare for more complex and costly health care over the past decade — adding $11 billion or more to their fees — despite little evidence that elderly patients required more treatment.

The series also exposed a wide range of costly billing errors and abuses that have plagued Medicare for years — from confusion over how to pick proper payment codes to apparent overcharges in medical offices and hospital emergency rooms — and strongly suggested these problems have worsened with the rapid growth in the use of electronic medical records and billing software.

Here in Massachusetts, the effort is well underway. Here at the expected connections. Again, an HIT jargon alert.

ACO to ACO transmission – two large healthcare systems breaking down silos and exchanging lifetime summary records for care coordination

Provider to Registry transmission  – EHR data sent to a third party for computation of quality and performance metrics

Provider to Plan transmission – EHR encounter data sent from a provider organizations to a payer for care management

Pediatric Care Coordination – EHR transmission between a community provider and a tertiary referral hospital

Suburban to Urban Specialist referral – A PCP at a community site sends referral data to an urban specialist, electronically closing the loop between the two

Rounding up the year’s health news

Theirs and ours:

You can read Commonhealth’s list or listen to it on Radio Boston:

Or listen to Carey Goldberg on WBUR

MassDevice offers : The top medical device stories of the year, Part I

From sweeping regulatory changes promised, but never delivered, by the FDA, to the industry and regulatory backlash against the impending 2.3% excise tax, the industry didn’t move the chains too far in the past twelve months.

The Globe offers Top Ten Health Apps and health advice from “prominant Bostonians.” The list includes dog walking, hoops to stave off Alzheimer’s,  meditation, all things in moderation, no desserts  –this did not come from the restaurateur –and volunteerism –this did come from a museum director.

Boston hospital CIO Halamka on his wife’s diagnosis: “We have cancer”

Beth Israel CIO John Halamka usually blogs about health information with posts like “The EHR/HIE Interoperability Workgroup,” and very occasionally, his life as a vegan or his plan to  retire to a small family farm to raise organic vegetables.

Today he reports the disturbing news of his wife’s breast cancer. They’ve decided to document her treatment in real time.

The headline “We have cancer.”

Last Thursday, my wife Kathy was diagnosed with poorly differentiated breast cancer. She is not facing this alone. We’re approaching this as a team, as if together we have cancer. She has been my best friend for 30 years. I will do whatever it takes to ensure we have another 30 years together.

She’s has agreed that I can chronicle the process, the diagnostic tests, the therapeutic decisions, the life events, and the emotions we experience with the hope it will help other patients and families on their cancer treatment journey.

Tweets from Boston meeting on health, the Internet and mobile communication

Check out #chs11 f for tweet from the Connected Health Symposium in Boston. Each year, Partners sponsors this meeting to look at how the Internet and mobile communication are changing the health care system.  Here’s a link to the Tweetstream and a few samples below from a session on social networking and health.

RT @MGHDiabetesEd: “online patient communities can increase engagement, decrease isolation.” #chs11
October 20, 2011
@taracousphd at #SoMe panel at #chs11: 35% of young people search for #healthcare informaton online
October 20, 2011
Giving patients the choice to use an alias-based identity on social networks is a key way to address privacy concerns #chs11
October 20, 2011
@dsgold How so? Alias identity does not equal unidentifiable, does it? I’d be concerned this is a false sense of security. #chs11
October 20, 2011
Facebooking health @taracousphd facebook campaigns have huge opportunity for reaching teens, can use it for health literacy #chs11
October 20, 2011
@lisagualtieri : There are credit #literacy programs for teenagers, why not more health literacy ones? #chs11
October 20, 2011
We need to be inter-generational in our social media “prescription” including seniors as well as youth #chs11
October 20, 2011
Social media can help make a disease more than just a disease for teens @drjosephkim #chs11
October 20, 2011
@drdannysands telling about how he prescribed acor to @epatientdave & it save his life #chs11 #s4pm
October 20, 2011
Next up, Facebooking Health moderated by my wonderful #TUSM colleague @lisagualtieri #chs11
October 20, 2011
@meyouhealth Chris Catter shows first ever social graph to visually render well-being among participants in social networks #chs11
October 20, 2011
CDC traditional data tracked same as social media during H1N1 #chs11
October 20, 2011
should MDs, nurses, etc recommend online pt communities? -yes! #chs11
October 20, 2011

In Cambridge, Mass., an “unconference” on #healthcare and the web #hit #healthfoo

“Unconference, ” “NERD center” and “Health Foo.” Find our what all that means and more in report on last weekend’s  Cambridge, Massachusetts meeting on health care and the web.

Or, as defined by the site “a cross-discipline, immersive, informal ‘unconference’ that will take advantage of a growing interest in applying Web 2.0 and open-source thinking in health care to spark ideas that can expedite changes in the ecosystem of health care services.”

On e-patients.net, poster Susanna Fox describes a session on why Google health failed and Cambridge-based Patients like Me succeeds. Fox is the “associate director of the Pew Internet & American Life Project and author of the Project’s survey reports on e-patients and online health”

-          Google created a private record, which was off-mission for Google since they do a great job of connecting people and aggregating data.

-          The ecosystem wasn’t ready and Google got “big company disease” so they bailed too early.

-          There are no lightweight solutions for such a broken system.

-          An EMR is the hardest problem to tackle and the least interesting for most consumers.

-          Google failed to make it easy for people to import data and use it.

-          Useful analytics, like Mint.com’s, would have been a saving grace.

-          A counterview: The minimal use case was compelling enough – an easy way to see last year’s test results next to this year’s. Just to see the data is enough for some people.

-          Outside the U.S., EMRs and health data tracking helps trigger vaccination reminders – another simple use case that is compelling to people.

-          Google was late or unable to get the developer community excited.

-          Companies need to come to the game with someone in mind, someone whose problem you want to solve.

-          PatientsLikeMe’s 4 keys: 1) the platform has to be awesome; 2) someone has to care about the individual; 3) understand what is meaningful about the problem being solved; 4) do research, help people take action.

-          This space is not about apps. It’s about a use case, a value proposition like “this will help you save money” or “this will help avert disaster.”

-          A successful future initiative would do well to focus on babies. Pregnancy and parenthood are gateway moments in people’s lives.

-          Let the data flow and the technology will work itself out.

The future for computers and health care

 Partners’ Kedvar asks – What is the future of The Center for Connected Health?

 I was recently asked to predict what our Center would be like 10 years hence.  Stated another way, the question was: “What is your ten year vision for your Center?”  My initial reaction was, “Of course I should be able to articulate that.” After all, our very capable team does all of the work here, so the most effective way for me to add value is to articulate a clear vision.  However 10 years is a long time and lots of intervening forces can influence the world.

 For a more technical take on a related question, John Halamka, also of Partners, asks:

 What do we need to ensure innovation and progress in clinical informatics?

 …(W)e have policy, technology, and funding initiatives which are sufficient to ensure innovation and progress in clinical informatics. Governance and a pipeline of trained professionals will ensure the foundation built today evolves to meet future needs. It’s a great time for clinical IT. Never before in history have so many factors been aligned for success.


HIT: Gearing up for computerized health care

So far, the “The Huffington Post” series on health information technology has pointed out some serious problems and potential complications — including a tech industry feeding frenzy and medical errors linked to computer or data entry glitches.  

Their most recent piece focuses on the upside — improving care. And, it offers a clear-eyed overview of intended benefits and the barriers to achieving them. They also explore whether HIT will have success in managing chronic diseases where some other approaches have failed.

Many experts contend digital systems not only will help doctors cut costs, but also improve care by reducing medical errors and waste. However, critics argue that the benefits are being oversold and that the stimulus plan provides a windfall to the technology industry. Others are calling for tighter government oversight to make sure that computerized systems marketed are safe and perform as promised.

They look at “Beacon Communities” : 15 medical groups nationwide – Brewer, Maine and Providence, R.I. among them – taking part in a $220 million government program designed to show how digital records technology promotes better health care and cuts costs. Twelve of the 15 centers awarded grants—some rural and others in major cities—will focus at least partly on diabetes, a disease that is both debilitating and expensive to treat.

For more Bay State HIT news, check out this radio piece on the effort to wire three Massachusetts towns. Can Computers Save Health Care?  (Note that the$50 billion  federal investment is now down to about $27 billion. Also, click here from more HIT news on BHN, including a video interview with John Glaser, for head of IT at Partners who recently moved to Siemens.

Finally, note that the feds last week rolled out their final rules on what they want to see in subsidized HIT systems.  Video here.

Artist and activist Regina Holliday represented the patient’s point of view. She spoke about her frustration with lack of access to her late husbands records during his unsuccessful cancer treatment. She offered a key reminder :”We’re all patients in the end.”

More on Holliday and the announcement here from the Health Beat Blog.

What is striking about her story is that Holliday is not complaining that the hospital didn’t “save” her husband. She is objecting to how little information she and her husband received: “the terror of not being told what was going on.” In other words, this is less about what treatment he did or didn’t receive than it is about how he was treated. Holliday is calling for “patient-centered care” that includes the patient in the decision-making loop, giving him the information he needs to make an informed choice.


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