Interviews about Medicine 2.0

“Medicine 2.0 is an interesting new field of medicine and focuses on how web 2.0 can change medical education and communication. Two interviews have recently been published about my views on this topic.”
Article
Bertalan Meskó, ScienceRoll, 1 October 2008

IBM introduces new mobile services for healthcare organizations

“IBM has announced new services to help healthcare organizations implement wireless mobility solutions.
IBM Enterprise Mobility Services is designed to give clinicians and nursing staff wireless communications and real-time access to patient records anywhere on the facility premises, according to IBM.”
Article
Bernie Monegain, Healthcare IT News, 12 September 2008

Electronic Health Records: A Global Perspective

“The HIMSS Global Enterprise Task Force (GETF) was asked to investigate efforts to implement electronic health record (EHR) in a host of countries around the world. GETF looked at a battery of Electronic Health Record (EHR) components within each country, including security, quality, financing sources and barriers to adoption. Four common threads that affect EHR implementation and produce a kinship between every effort around the globe were identified:
· Funding
· Governance
· Standardization and interoperability
· Communication
Local and nationwide efforts to realize EHR systems were intermittently reported in all the countries we studied. When analyzing these efforts, the common threads listed above helped to explain the success, barriers or implementation failures experienced in each country.”
Report
HIMSS, August 2008

HIMSS identifies global EHR implementation trends

“Electronic health record implementations are affected by four common factors across the globe, according to a task force of the Healthcare Information and Management Systems Society.
The 16-member Global Enterprise Task Force reviewed EHR implementations at healthcare IT centers in 15 countries in North America, Europe, Asia Pacific and the Middle East.”
Article
Chip Means, Healthcare IT News, 9 September 2008

HealthVault. RelayHealth partnership boosts patient, doc connection

“Microsoft’s HealthVault and McKesson’s RelayHealth will partner their offerings with the goal of providing patients with greater access to physicians and personal health information and physicians with greater access to data to improve patient care.
HealthVault, which allows patients to store, manage and share their personal health records, will use RelayHealth’s Software-as-a-Service platform to enhance its online patient service and communications.”
Article
Molly Merrill, Healthcare IT News, 25 July 2007

Journal of Telemedicine and Telecare, TOC, July 2008

Telerehabilitation for service delivery in speech-language pathology
“Communication disorders in adults and children can have a significant effect on their quality of life and on that of their families. Speech-language pathologists face several challenges in providing assessment and treatment services to such people. Challenges include facilitating equitable access to services and providing appropriate management within a changing social and economic context. Telerehabilitation has the potential to deliver services in the home or local community via videoconferencing and through interactive computer-based therapy activities. This form of service delivery has the capacity to optimize functional outcomes by facilitating generalization of treatment effects within the person’s everyday environment, and enable monitoring of communication and swallowing behaviours on a long-term basis. A number of image-based telerehabilitation applications have been used in the management of adult neurogenic speech and language disorders, stuttering, voice disorders, speech and language disorders in children, laryngectomy and swallowing dysfunction. Further development of such applications and other computer-based therapies, cost-benefit and cost-effectiveness analyses, and professional education are needed if telerehabilitation is to become an integral part of speech-language pathology practice.”
Abstract
Deborah G Theodoros, J Telemed Telecare 2008;14 221-224, doi:10.1258/jtt.2007.007044

Telehealth: a child and family-friendly approach to mental health-care reform
“Limited access to paediatric mental health services and high drop-out rates from treatment result in poor health outcomes for families with children with mental health problems. New ways of delivering care are required. Telehealth is a promising approach. The Family Help programme employs manualized, distance treatment by telephone. Participants in the Family Help programme (both adults and children) have reported a strong therapeutic alliance with their telephone coach. Participants also described how during treatment sessions they felt comfortable and safe in their own home; they did not feel stigmatized or judged; they had little apprehension about self-disclosure and they felt that treatment was delivered at their convenience. Treatment calls were often scheduled after typical working hours. Attrition rates were found to be very low and children actively engaged in the structured, distance treatment. Evidence-based, distance delivery using non-professionals is a promising approach to the delivery of paediatric mental health care.”
Abstract
Patricia Lingley-Pottie and Patrick J McGrath, J Telemed Telecare 2008;14 225-226, doi:10.1258/jtt.2008.008001

Effect of a behavioural health and specialty care telemedicine programme on goal attainment for youths in juvenile detention
“We conducted a pre-post study of the effect of a telepsychiatry counselling service on youths housed in three juvenile detention facilities. In the first year of the telemedicine programme, 321 psychiatry consultations were conducted via telemedicine; in the second year of the programme, 573 psychiatry consultations were conducted. Records for 190 students were then examined by two raters. The total number of behavioural goals for each adolescent increased from 8.2 in the pre-telemedicine year to 8.7 in the first year of telemedicine and then to 10.0 in the second year (P < 0.05). In Year 2 of the study, subjects also had a significantly higher number of goals in four of the five categories: education, family, health and social skills (P < 0.05). Although other changes at the youth detention facilities or in the juvenile justice system may have been partly responsible for the effects observed, the study suggests that telemedicine may be useful for improving the rate of attainment of goals associated with family relations and personality/behaviour."
Abstract
Karen C Fox, Pamela Connor, Elizabeth McCullers, and Teresa Waters, J Telemed Telecare 2008;14 227-230, doi:10.1258/jtt.2008.071102

Non-invasive monitoring of the activities of daily living of elderly people at home – a pilot study of the usage of domestic appliances
“We conducted a feasibility study of a system for non-invasive monitoring of subjects at home. Electrical activity was recorded from room lights and from electrical domestic appliances; this was translated into the probability of physical activity or a particular Activity of Daily Living (ADL). Thirteen volunteer subjects were monitored for a period of 6.4 months (range 3–8). The mean age of the subjects was 80 years and they all lived alone at home; one had moderate Alzheimer’s disease. A one-week validation was carried out to ascertain whether the recorded activity actually occurred. The results showed that daily and nocturnal activity could be well differentiated. The probability of having eaten, taken a bath and going to the toilet could be calculated each day. Eating was the most accurately measured ADL; toileting and bathing results were less accurate. The system appears to be a promising component of home telecare.”
Abstract
Georgina Corte Franco, Floriane Gallay, Marc Berenguer, Christine Mourrain, and Pascal Couturier, J Telemed Telecare 2008;14 231-235, doi:10.1258/jtt.2008.071207

A paediatric therapeutic alliance occurs with distance intervention
“We investigated whether a distance therapeutic alliance occurs when children receive manualized, cognitive-behavioural treatment via telephone, in the absence of face-to-face contact. The therapeutic alliance scores were measured in 55 child–parent pairs. The mean total Working Alliance Inventory child scores were 236 (95% confidence interval [CI]: 232, 240) and the mean parent scores were 245 (95% CI: 242, 247). Parent scores were significantly higher than child scores, although the difference may not be clinically meaningful. This study provides evidence that a strong therapeutic alliance does occur between child–coach and parent–coach pairs when treatment is delivered from a distance by non-professionals. The term ‘child’ encompasses both children and adolescents.”
Abstract
Patricia Lingley-Pottie and Patrick J McGrath, J Telemed Telecare 2008;14 236-240, doi:10.1258/jtt.2008.080101

International telepsychiatry: a study of patient acceptability
“An international telepsychiatry service was established between Denmark and Sweden for cross-cultural patient groups, such as asylum seekers, refugees and migrants. Over an 18-month period starting in mid 2006, 30 patients were treated by telepsychiatry (21 men and 9 women). The patients received mental health care by videoconferencing from providers who spoke the patients’ own language, i.e. without the assistance of interpreters. The total number of telepsychiatry sessions was 203 (range 1–22; average 6.8 sessions per patient). Patients completed a satisfaction questionnaire at the end of treatment. Seven patients (23%) were not able to complete a questionnaire, due to illiteracy and/or a psychotic condition. The rest of the patients (n=23) reported a high level of acceptance and satisfaction with telepsychiatry, as well as a willingness to use it again or recommend it to others. Any disadvantages of telemedicine were compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. Mentally ill asylum seekers, refugees and migrants are under-served in their mother tongue and telepsychiatry can improve access to scarce health-care resources.”
Abstract
Davor Mucic , J Telemed Telecare 2008;14 241-243, doi:10.1258/jtt.2008.080301

The availability of telecardiology consultations and transfer patterns from a remote neonatal intensive care unit
“We examined records of all admissions to an isolated community neonatal intensive care unit (NICU) in California between 2001 and 2006. We also reviewed the echocardiograms for diagnosis, disposition of patient and necessity for transport. In 2004, a telemedicine link (mainly store-and-forward) was established to a university children’s hospital (UCH) 290 km away. The number of NICU patients having an echocardiogram increased from 280 (27% of 1029 admissions) to 385 (40% of 963, P = <0.001) after telemedicine became available. There was an increase in the proportion of normal studies, from 31% to 37% (P = 0.03), and an increase in the number of patients diagnosed with cardiac pathology from 192 (19% of all admissions) to 241 (25%, P < 0.001). Twenty-four patients were transferred for cardiac reasons during each three-year period; however seven pre-telemedicine transfers were avoidable, compared with two post-telemedicine transfers (P = 0.06). There was a change in referral pattern (65% to the UCH pre-telemedicine, compared with 78% post-telemedicine) although it was not significant (P = 0.10). Thus the availability of the telecardiology link was associated with increases in the utilization of echocardiography, in the proportion of normal studies, and in the percentage of neonates diagnosed with cardiac pathology without an increase in the number transferred for cardiac reasons. There was a reduction in unnecessary transfers and a strengthened relationship with the centre providing the telecardiology service."
Abstract
Tannie Huang, Anita J Moon-Grady, Craig Traugott, and James Marcin, J Telemed Telecare 2008;14 244-248, doi:10.1258/jtt.2008.080102

Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis
“We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervention would be at least the same as those measured after a period of usual care for patients with stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) with respect to their arm/hand function. Eighty-one patients with affected arm/hand function resulting from either stroke, MS or TBI were recruited in Italy, Spain and Belgium; 11 were lost during follow-up (14%). The outcome measures were the Action Research Arm Test (ARAT) and the Nine Hole Peg Test (NHPT). There were no significant differences between the two groups on the outcome measures (ARAT and NHPT); in both groups, patients maintained or even improved their arm/hand function. The HCAD training was found to be as feasible as usual care in terms of clinical outcomes, and both therapists and patients were satisfied with the HCAD intervention. A telerehabilitation intervention using HCAD may increase the efficiency of care.”
Abstract
Barbara CH Huijgen, Miriam MR Vollenbroek-Hutten, Mauro Zampolini, Eloy Opisso, Montse Bernabeu, Johan Van Nieuwenhoven, Stephan Ilsbroukx, Riccardo Magni, Claudia Giacomozzi, Velio Marcellari, Sandro Scattareggia Marchese, and Hermie J Hermens, J Telemed Telecare 2008;14 249-256, doi:10.1258/jtt.2008.080104

Satisfaction with care in post-stroke patients undergoing a telerehabilitation programme at home
“We conducted a pilot telerehabilitation study with post-stroke patients with arm motor impairment. We compared the degree of satisfaction of patients undergoing a virtual reality (VR) therapy programme at home (Tele-VR group) to satisfaction experienced by those undergoing the same VR therapy in a hospital setting (VR-group). The rehabilitation equipment used a 3D motion tracking system to create a virtual environment in which the patient’s movement was represented. In tele-therapy, the patient equipment was installed in their homes, connected to the hospital by four ISDN lines at a total bandwidth of 512 kbit/s. Rehabilitation data were transmitted via one line and videoconferencing via the other three. Ten patients with mild to intermediate arm motor impairment due to an ischaemic stroke, were randomized into VR or Tele-VR groups. A questionnaire was used at the end of treatment to measure each patient’s degree of satisfaction. Tele-VR treated patients showed median values equal to or higher than the VR group patients in all 12 items investigated, except one. In motor performance, the Tele-VR group improved significantly (P ? 0.05), while the VR group showed no significant change. Patients assigned to the Tele-VR group were able to engage in therapy at home and the videoconferencing system ensured a good relationship between the patient and the physical therapist whose physical proximity was not required.”
Abstract
Lamberto Piron, Andrea Turolla, Paolo Tonin, Francesco Piccione, Lisa Lain, and Mauro Dam, J Telemed Telecare 2008;14 257-260, doi:10.1258/jtt.2008.080304

Caregivers’ acceptance of electronic documentation in nursing homes
“A comparative study was conducted in two Australian nursing homes operated by the same organization. One home had implemented an electronic documentation system and the other remained paper-based. Survey questionnaires were answered by 14 of the 17 caregivers at the electronic documentation site (82%) and 10 of the 23 caregivers at the paper documentation site (43%). They provided opinions about satisfaction with their home’s documentation system, and the training and support provided. Information was also obtained on the caregivers’ attitudes towards using electronic documentation. The caregivers at the electronic documentation site quickly adapted to the use of the new technology after receiving effective training and support. Caregivers at both homes were satisfied with their homes’ documentation system, and had positive attitudes towards using electronic documentation systems. As an important communication tool, electronic nursing documentation may lead to improved efficacy of telemedicine in nursing home settings.”
Abstract
Ping Yu, David Hailey, and Haocheng Li, J Telemed Telecare 2008;14 261-265, doi:10.1258/jtt.2008.080310

The use of videoconferencing for mental health services in Finland
“The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts. The overall rate of TMH consultations was 4 per 100,000 population. The highest TMH consultation per population ratio, 22 per 100,000, was in northern Finland. Most of the sites used telepsychiatry services for less than 10% of clinical outpatient services. The sites with over 20% utilization of clinical TMH services from all psychiatric consultations were all rural health centres. Compared with Finland, the utilization rates of TMH were higher in Canada; that might be due to differences between the countries in the organization of mental health services in primary and specialized care. In Finland TMH consultations made up only a very small proportion of all mental health services. The use of TMH was particularly common in remote areas; however, there were many rural centres that did not utilize clinical TMH. TMH was widely utilized for continuing and medical education.”
Abstract
Arto Ohinmaa, Risto Roine, David Hailey, Marja-Leena Kuusimäki, and Ilkka Winblad, J Telemed Telecare 2008;14 266-270, doi:10.1258/jtt.2008.071212

Use of mobile phone cameras for after-hours triage in primary care
“Mobile phone images might be useful in after-hours triage of primary care. We conducted a study to identify population access to mobile phone cameras and to assess the clinical usefulness of mobile phone cameras. The survey was conducted among 480 patients attending two rural New Zealand practices. There were significantly more Maori owners compared to non-Maori (P = 0.002). Age was a significant factor influencing the ownership of mobile phones. We also conducted a clinical quiz among health professionals to assess how the provision of images on a mobile phone and on CD-ROM (to simulate the image that would be seen if email was used to transmit the images) influenced diagnostic confidence. Ten photographable clinical conditions were used to quiz 30 health professionals who were randomized into three groups of 10 each on diagnostic confidence. Images were found to significantly increase diagnostic confidence in all cases except one. It appears that mobile phone cameras are generally acceptable to patients and likely to be of practical use to rural practitioners in a range of clinical scenarios.”
Abstract
Chandra Jayaraman, Paul Kennedy, Gaelle Dutu, and Ross Lawrenson, J Telemed Telecare 2008;14 271-274, doi:10.1258/jtt.2008.080303

SCR could hold ‘end of life’ plans

“The Summary Care Record (SCR) could be used to share end of life care plans and resuscitation details, according to the Department of Health.
Its newly-launched End of Life Care Strategy recommends that all end of life care providers have access to N3 and the SCR.”
Article
e-Health Insider Primary Care, 22 July 2008

Electronic records help doctors, patients work together

“Access to the records enables prompt, effective care, whether patients are in their hometown or traveling, have forgotten the name of a medicine or are suffering from an illness or injury that makes them unable to communicate.”
Article
Connie Midey, The Arizona Republic, 15 July 2008

Electronic Medical Records: Leveraging Adoption Through Increased Consumer Awareness

“The word “transparency” seems to be at the forefront when discussing point-of-care technology adoption. Is the point of an electronic medical record (EMR) system transparent to the physician? Are the benefits of such a system transparent enough for smaller practices to disregard the cons? How can we make the value of an EMR system more transparent even if the physician does not access advanced features? But the real question we may want to ask is whether we are applying the word transparency to the wrong party; rather should we be assessing the transparency of the point/benefits/value of an EMR system with regard to the consumer instead?
Report
Erika S. Fishman, Manhattan Research, July 2008

Building an inter-organizational communication network and challenges for preserving interoperability

“Abstract
Background: The ideal scenario for information technology to bridge information gaps between primary and secondary healthcare and to improve the quality of healthcare in the medication process is to build an interoperable communication network. This type of undertaking requires diverse information systems to be integrated, and central to this are the preservation of data integrity and the integration of different pieces of patient data.
Objectives and methodology: In this study, we focused on sources of challenges to the integration process and to the building of an interoperable communication network. Interviews, document analysis, and observations were conducted to evaluate the integration process in a project that involved medication data communication between primary healthcare providers (i.e., general practitioners and community pharmacists) and secondary healthcare providers (i.e., hospital pharmacists and specialist physicians).
Results: The project encountered numerous integration problems, many of which persisted even after extensive technical intervention. An analysis of the problems revealed that they were mostly rooted either in problematic integration of work processes or in the way the system was used. Despite the project’s ideal technical condition, the integration could be accomplished only by applying human interfaces.
Conclusion: The main challenge to building interoperable communication network does not lie in technical integration. The real problem occurs when the technical linkage is implemented without the work processes being aligned and integrated.”
Abstract
H. Pirnejad, R. Bal and M. Berg, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 25 June 2008, doi:10.1016/j.ijmedinf.2008.05.001

Health Language Technology Translates Medical Terminology and Administrative Billing Codes into Consumer-Friendly Terms

“Health Language, Inc. (HLI), the world’s leading supplier of “language engine” technology, today announced a powerful, new content set that allows for translation of medical terminology and billing codes into easily-understood consumer terminology for streamlined communication of patient data to consumers, physicians and health plans.”
Article
PR-Inside, 18 June 2008

Supporting Quality with Information Technology

“Next week, I’m meeting with the BIDMC Board’s Patient Care Assessment and Quality Committee (PCAC) to discuss the 2009 tactics for improving quality with information technology. The overall presentation includes 2008 accomplishments, 2009 goals, the national context, and our general approach. I’ve chosen to communicate the specifics in the context of the Joint Commission’s 2008 Patient Safety Goals.”
Article
John Halamka, Life as a Healthcare CIO, 18 June 2008

Pris til norsk telemedisin

A telemedicin project involving Norway, Denmark, Sweden, Estonia en Lithuania gets Amercian Price for medical communication.

Article (Norwegian)
Nard Schreurs, Computerworld Norway, 8 June 2008

Prescribing Assistive-Technology Systems: Focus on Children With Impaired Communication

“Abstract
This clinical report defines common terms of use and provides information on current practice, research, and limitations of assistive technology that can be used in systems for communication.The assessment process to determine the best devices for use with a particular child (ie, the best fit of a device) is also reviewed. The primary care pediatrician, as part of the medical home, plays an important role in the interdisciplinary effort to provide appropriate assistive technology and may be asked to make a referral for assessment or prescribe a particular device. This report provides resources to assist pediatricians in this role and reviews the interdisciplinary team functional evaluation using standardized assessments; the multiple funding opportunities available for obtaining devices and ways in which pediatricians can assist families with obtaining them; the training necessary to use these systems once the devices are procured; the follow-up evaluation to ensure that the systems are meeting their goals; and the leadership skills needed to advocate for this technology. The American Academy of Pediatrics acknowledges the need for key resources to be identified in the community and recognizes that these resources are a shared medical, educational, therapeutic, and family responsibility. Although this report primarily deals with assistive technology specific for communication impairments, many of the details in this report also can aid in the acquisition and use of other types of assistive technology.”
Article
Larry W. Desch, Deborah Gaebler-Spira and the Council on Children With Disabilities, Pediatrics Vol. 121 No. 6 June 2008, pp. 1271-1280 (doi:10.1542/peds.2008-0695)

The Efficient MD -Eavesdrop on Doctors and Medical Students on Twitter

“One MD discusses using Twitter….several others are beginning to use the platform and I have signed up but have not added the Medical Quack yet…perhaps soon…John Mack in the pharma area has moved on to Twitter as well, but as of this morning the network was experiencing some issues…Twitter stated it was due to the rapid increase of clients…well time will tell the story as to how efficient Twitter will be… BD”
Article
The Medical Duck, 30 May 2008

Doctors and Medical Students on Twitter

Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications

“Background: Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care.
Objective: The aim of this study was to determine user-centered criteria for successful application of Internet-based technology used in primary care for supporting self-care.
Methods: We conducted scenario-based tests combined with in-depth interviews among 14 caregivers and 14 patients/consumers to describe the use of various self-care applications and the accompanying user problems. We focused on the user-friendliness of the applications, the quality of care provided by the applications, and the implementation of the applications in practice.
Results: Problems with the user-friendliness of the self-care applications concerned inadequate navigation structures and search options and lack of feedback features. Patients want to retrieve health information with as little effort as possible; however, the navigation and search functionalities of the applications appeared incapable of handling patients’ health complaints efficiently. Among caregivers, the lack of feedback and documentation possibilities caused inconvenience. Caregivers wanted to know how patients acted on their advice, but the applications did not offer an adequate feedback feature. Quality of care problems were mainly related to insufficient tailoring of information to patients’ needs and to efficiency problems. Patients expected personalized advice to control their state of health, but the applications failed to deliver this. Language (semantics) also appeared as an obstacle to providing appropriate and useful self-care advice. Caregivers doubted the reliability of the computer-generated information and the efficiency and effectiveness of secure email consultation. Legal or ethical issues with respect to possible misuse of email consultation also caused concerns. Implementation problems were mainly experienced by caregivers due to unclear policy on email consultation and the lack of training for email consultations.
Conclusions: Patients’ and caregivers’ expectations did not correspond with their experiences of the use of the Internet-based applications for self-care. Patients thought that the applications would support them in solving their health problems. Caregivers were more reserved about the applications because of medico-legal concerns about misuse. However, the applications failed to support self-care because eHealth is more than just a technological intervention. The design of the applications should include a way of thinking about how to deliver health care with the aid of technology. The most powerful application for self-care was secure email consultation, combined with a suitable triage mechanism to empower patients’ self-awareness. Future research should focus on the effectiveness of such Web-based triage mechanisms for medical complaints and on the development of interactive features to enhance patients’ self-care.”
Article
Nijland N, van Gemert-Pijnen J, Boer H, Steehouder MF, Seydel ER, J Med Internet Res 2008;10(2):e13

The Talking Cure

“A trip to the doctor is the start of a conversation that provides the link between our everyday lives and the medical profession. Each day in the UK more than a million conversations take place between doctors and patients. When governments, policy makers and others talk about healthcare, these conversations often fade into the background. But conversations are the foundation for our health, with enormous potential impact.”
Report
Jack Stilgoe, Faizal Farook, Demos, May 2008

Silverlink, IncentOne aim to make health and wellness an easy choice

“Through its Adaptive HealthComm Science platform, Silverlink combines technology with decision support methodologies to deliver personalized, one-on-one communications to preconfigured populations, such as health plan participants. Silverlink’s customer base includes nine of the nation’s top 10 health plans as well as pharmacy benefit managers, medical supply companies and population health companies.”
Article
Eric Wicklund, Healthcare IT News, 14 May 2008

Kaiser completes outpatient EHR rollout

“Kaiser Permanente has completed the rollout of its outpatient electronic health record system in nine states and the District of Columbia. Kaiser’s 13,000 physicians in 421 offices now have electronic access to their patients’ medical records.”
Article
Bernie Monegain, Healthcare IT News, 5 May 2008

What we have in health care today is a failure to communicate

“Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure.
Patients are rushed through office visits and often leave without having their questions answered. Labyrinthine barriers have to be overcome before speaking with a physician. Reaching a medical provider via the Internet is an impossibly daunting task. Doctors rarely talk to each other to coordinate treatment plans.”
Article
Kevin Phon, Nashua Telegraph, 4 May 2008

Developing informatics tools and strategies for consumer-centered health communication

Abstract:
As the emphasis on individuals’ active partnership in healthcare grows, so does the public’s need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This white paper presents an overview of the consumer health informatics field, discusses promising approaches to supporting health communication, and identifies challenges plus direction for future research and development. The authors’ recommendations emphasize the need for drawing upon communication and social science theories of information behavior, reaching out to consumers via a range of traditional and novel formats, gaining better understanding of the public’s health information needs and developing informatics solutions for tailoring resources to users’ needs and competencies. This paper was written as a scholarly outreach and leadership project by members of AMIA’s Consumer Health Informatics Working Group.”
Article
Alla Keselman, Robert Logan, Catherine Arnott Smith, Gondy Leroy, and Qing Zeng-Treitler, Journal of the American Medical Informatics Association 2008, April 24, 2008 as JAMIA PrePrint; doi:10.1197/jamia.M2744

Pharmaceutical industry lags behind on the Internet

“Pharmaceutical companies have been slow to take advantage of the marketing opportunities offered by the Internet - and if the industry doesn’t develop new online strategies, it will be left behind.
This ominous assessment comes from a new market research report, titled “Reaching doctors and patients through new digital media.”
Article
Richard Pizzi, Healthcare IT News, 24 April 2008

Architectural Approaches to Health Information Systems for Empowering the Subject of Care

Abstract:
The personal health paradigm puts the citizen in the health services business process center. This enhances the subject of care’s opportunities, rights and duties regarding his/her health status and the process for maintaining and improving it. First, the citizen and his/her direct environment have to become part of the health information systems network. This implies diagnostic and therapeutic processes performed to the subject of care independent of time, location and local resources by closing the gap through appropriate mobile and miniaturized medical devices up to an implantable level. The individualization of care delivery services requires individualized diagnostic and therapeutic means based on bioinformatics and genomics methodologies. As the individual needs of a subject of care are not predictable, the system architecture must adaptively and autonomously, integrating all domains defining eHealth. Second, the architecture must be policy-controlled for empowering the subject of care, offering all privacy and security services needed. Third, embedded in the system architecture, the subject needs the knowledge presented in the right way using the right terminology to enable the intended empowerment.

Bernd BLOBEL, Peter PHAROW
eHealth Competence Center, University of Regensburg Medical Center, Regensburg, Germany

To be published in “Medical and Care Compunetics 5?, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

New FP7 eHealth Project - MEDNet

“MEDNet Project will develop a medical network that addresses the problems of providing health care from a distance. The medical network will be supported by expert physician located in urban cities of Latin America. The medical applications will be vary from gynaecology, paediatric, cardiology to typical infectious diseases for the region such as malaria and tuberculosis.”
Article
eHealthNew.eu, 21 April 2008

Knowledge Management: the key to network-centric healthcare

“The adoption and diffusion of e-health and the application of Information and Communication Technologies (ICTs) in healthcare is being heralded as the panacea. In this context, a model of network-centric healthcare operations has been proffered as the best way to maximise the benefits of ICT as well as to facilitate the rapid sharing of information and effective knowledge building required for the development of coherent objectives and their subsequent attainment. Integral to the success of such a model is the need to embrace the tools and techniques of Knowledge Management (KM) as elaborated upon in the following paper.”
Abstract
N. Wickramasinghe, R.K. Bali, International Journal of Biomedical Engineering and Technology 2008 - Vol. 1, No.3 pp. 342 - 352, DOI: 10.1504/IJBET.2008.016966

Health IT: The Time Is Now

“Americans need and deserve health information technology (IT). As the chairman and CEO of Verizon Communications Inc. and the only business representative on a federal commission to develop a strategy for health care IT standards, I have spent considerable time over the past several years promoting this technological necessity.”
Article
Ivan Seidenberg, Health Affairs 2 April 008

Personals Attitudes towards Robot Assisted Health Care – a pilot study in 111 respondents

Abstract:
Background: The aim of this survey was to examine health care professional’s attitudes towards technology involving support from artificial intelligence (AI), robots and humanoids. Within 10-15 years, every third student has to choose occupation within the health care sector to obtain the current personal level, due to the aging population and retirement within the health service sector.
Material & Methods: The preliminary investigation interviews presented a wide range of activities. These were nursing tasks, service tasks, monitoring/alarms, telemedicine and social communication. First, a five minutes presentation movie was presented. The movie demonstrated expected personal needs in the future and what robots and AI can do today and tomorrow. After this presentation, the 111 respondents, from different representative care institutions, replied on a questionnaire that dealt with selected areas identified above. The questions included different views of robots as supported aids in healthcare.
Results & Discussion: The respondents were overall negative using AI and robot technology related to caring activities. However, all groups were positive in using robots in service tasks, monitoring/alarms, telemedicine and social communication. Of 29 assertions, 18 were mostly positive and 13 of them were over 70 % positive. The frequency of positive and negative attitudes, were similar in the central areas. Within the caring area, a positive robot assisted task requires an interaction (collaboration): caregiver-robot-individual and subsequently, within the nursing area; robot assisted tasks must involve a certain degree of human caring.

Ola Göransson¹, Krister Pettersson¹, Pär A Larsson^1,4, Bo Lennernäs^2,3
1 Fyrbodal Research Institute, Uddevalla,
² Sahlgrenska Academy, Dept of Oncology, University of Gothenburg,
³ iRobis Vasaplatsen 2, 41134 Gothenburg,
⁴ Sahlgrenska Academy, Dept of Neuroscience and Physiology, University of Gothenburg,
All Sweden.

To be published in “Medical and Care Compunetics 5″, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

Combining Internet With Office Visits Cut Heart Attack Risks

“Whether it’s done in person or electronically, good doctor-patient communication helps reduce the risk of heart disease, says a Temple University School of Medicine study.”
Article
Washington Post, 30 March 2008

The Safe Implementation of Research into Healthcare Practice

Abstract:
Miscommunication, misunderstanding and outright error have all played significance roles in triggering Adverse Events across the spectrum of health care delivery. As a means of countering these effects this paper outlines a twin track approach. This firstly focuses on developing a care pathway modelling approach both as the basis for better understanding of interdisciplinary process interaction, and also as a means of rapid access to relevant clinical knowledge. This is then set in the context of the human behavioural issues that can all too easily prejudice patient safety. It also explores the potential to apply the large body of knowledge and experience in risk management techniques applied to life critical decision taking under high stress conditions.

Bryan MANNING and Stephen BENTON^b
University of Westminster, School of Informatics and Centre for Business Information, Organisation, and Process Management, Westminster Business School
^b Business Psychology Centre, University of Westminster, Department of Psychology

To be published in “Medical and Care Compunetics 5″, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

FDA, AMA, Others Back New Healthcare Notification Network

“A coalition of medical societies, malpractice insurers, pharmaceutical and medical device manufacturers, health plans, and government agencies is trying to end the era of paper patient-safety alerts with the launch of an electronic network to disseminate wide-scale drug and device recalls and warnings.”
Article
Neil Versel, Digital Healthcare & Productivity, 25 March 2008