Wednesday, January 31, 2007

RemedyFind: Health condition treatment info, patient ratings

RemedyFind: Health condition treatment info, patient ratings: "Sometimes being diagnosed with a health condition brings as much frustration as relief. Even with the best doctor care, many health problems just don't have clear-cut, predictable solutions. Out of necessity, many of us choose to become actively involved in our own healthcare decisions. But making sense of all the treatment options can be enormously confusing. That's why we've created RemedyFind. At RemedyFind we've listed the different treatments (remedies) that are used for specific health conditions. By giving a number rating to those remedies you have tried, you are able to share your personal health experiences with others.

Obviously, there are no guarantees that what works for one person will work for another. Still, by quantifying the results of our actual experiences - both good and bad - RemedyFind serves as a community where our collective, real-life health wisdom is pooled, thus saving time, energy and money as we cope with and eventually conquer debilitating illnesses."

Doc, give me a baby !

This is the commonest request new patients have when they come to me for a consultation. While it's a completely honest cry from the heart, unfortunately it's not a very sophisticated or helpful way of talking to a doctor. I tell patients that they need to think through their options carefully so that I can help them more effectively - I need their help in order to help them !

Infertility treatment is always elective - it's taken by choice. It's never an emergency, and there are always multiple options available to couples. For example, these include: childfree living; adoption; or medical treatment ( including IVF and the use of donor eggs and donor embryos). While all these are perfectly valid solutions, patients need to decide which option they prefer, so I can then help them achieve their goal.

This means that it's not enough for them to allow the infertility specialist to tell them what to do - they need to provide their inputs, so that with a little help from me, together we can achieve their heart's desire.

Health Advice Online: Your Personal Online Medical Advice -

Health Advice Online: Your Personal Online Medical Advice - "Need to exercise, lose weight or improve your diet?

Whether your goal is to simply improve your nutrition and start exercising or to shed those extra pounds, your Online Health Coach will tailor a program to your specific needs and help you look and feel healthier. Your coach will show you tools like the Calories Burned Calculator and the Portion Sizer, and informative slideshows and exercise demos. So fill your fridge with heart-healthy foods, put on your sneakers and start walking down the path to a healthier you."

Personal Health Record: Manage Your Medical Records and Medical History -

Personal Health Record: Manage Your Medical Records and Medical History - " Free, easy to use and completely secure, the PHR allows you to manage your family's medical records on-line - 24 hours a day, seven days a week.

Use the calendar to keep track of medical appointments, lab tests, prescription refills and appointments.

Schedule e-mail reminders so you never again forget an important doctor's appointment, medication refill, immunization or lab test.

Record medications and check for drug interactions. Don't worry about the spelling. The database will recognize a partial or close spelling and allow you to select the drug from a list. When you add a new medication, you'll be notified of any potential interactions with other drugs you are taking. "

Why I have the best job in the world !

People often ask me what I do for a living. I tell them I have the best job in the world - I get women pregnant, and I get paid for it ! When they raise their eyebrows in surprise, I explain I am an IVF specialist...

Sunday, January 28, 2007

Your PHR and Your Doctor

Your PHR and Your Doctor : " How will my PHR help my doctor?

When you maintain your PHR, you will enhance communication between you and your doctor. You will be able to knowledgably discuss your health information and medical history with your doctor, and provide updates to any changes in your health and wellness, such as updates on information you are tracking on your own such as glucose readings and updates on medications including over-the-counter medications you may be taking.

PHR enables you to easily communicate your health information. You can create reports with one click of a button on anything from your medical history, your medication list, to a graph of your blood pressure readings. You can print a report and take it with you, email reports, or if you are using the portable Personal HealthKey, your provider may plug your HealthKey into the USB port of his/her computer to view, transfer, or print reports right in the office."

Your PHR will help your doctor(s) to help you !

Quicken Health

Quicken Health: " Explanations of benefits! Doctor bills! FSA reimbursements! HSA Substantiations! The list of paperwork & information people have to manage for their basic healthcare goes on and on and until now, there has been no help.

Imagine a solution that will consolidate and organize the flood of healthcare information in one click. Imagine an easy to use tool people will turn to when they need to make better healthcare decisions. Imagine leveraging the lessons learned from connecting Quicken Personal Finance Software to more than 4,000 financial institutions. Now imagine Quicken — for healthcare.

Right now, Quicken is developing products and services that will simplify the way millions of American consumers manage their healthcare."

Health 2.0: Do-it-yourself health care has arrived

Health 2.0: Do-it-yourself health care has arrived : "We all know the health-care system is a $2 trillion dinosaur of the way-old economy. So where's the opportunity in that? Everywhere. But forget about trying to drag doctors, insurers, and hospitals into the Internet age. That was Health 1.0. Instead, if you're looking to start a health-related business, focus on the real customers - you know, the ones formerly known as patients. First they used the Net to educate themselves and shake up the medical establishment's Marcus Welby-era doctor-knows-best mentality. Now they're starting to control their own medical spending. Thanks to health savings accounts, people are moving over to 'consumer-directed health plans' - you, the patient, get a health-care budget from your employer and manage your expenses accordingly. That means you'd better shop around before opting for a $2,000 MRI."

Friday, January 26, 2007

HELP stars in Mumbai Mirror

What’s a Pound of Prevention Really Worth? - New York Times

What’s a Pound of Prevention Really Worth? - New York Times: "But his larger point is a perfectly good one: we now know an enormous amount about how to prevent heart attacks, with powerful drugs like statins, smoking cessation, exercise and diet. With the right preventive care, people can cut their risk of a heart attack by up to 80 percent, cardiologists estimate.

Which is exactly the atmosphere Dr. Agatston’s practice tries to create. Nurses there give patients specific cholesterol goals to meet and help them deal with the side effects of the drugs they are taking. A nutritionist, Marie Almon, meets with patients frequently enough to discuss real-life issues like how to stick to a high-fiber Mediterranean diet even on a cruise or a business trip.

There is only one problem with this shining example of a medical practice: it is losing money."

But what doctors get paid for is what doctors do !

HealthFair USA

HealthFair USA: " We are the next generation of preventive medicine. Featuring state-of-the-art, advanced mobile screening centers we call “Health Coaches,' HealthFair USA provides
vital, potentially lifesaving testing, including exclusive Advanced Biometrics. All this with unprecedented JCAHO accreditation. See
for yourself how HealthFair USA truly is pioneering prevention."

If the mountain won't come to Mohammed, then Mohammed needs to go to the mountain ! This is a clever way of delivering healthcare to where the patient is !

Thursday, January 25, 2007


Sensemaking: "Here’s an important question for all of us: How do you make sense of something that’s big and complicated? For the past several years I’ve been thinking a great deal about sensemaking—that is, the processes people go through when trying to “make sense” of a body of knowledge."

Patients need to try to make sense of a lot of complex medical information about their disease, and this can be a daunting task. Here are some useful tips as to how to go about making sense of your illness, and applying what you learn to your own problem !

Wednesday, January 24, 2007

Owning The Channel: Pharmaceutical Companies Race To Dominate Patient-Physician Communication

Owning The Channel: Pharmaceutical Companies Race To Dominate Patient-Physician Communication

What pharmaceutical companies are doing online to sell to doctors !

Doctors must not be lapdogs to drug firms

Doctors must not be lapdogs to drug firms : "Corporate support of continuing medical education courses, meals, and treats are not merely our just rewards for being hardworking, dedicated doctors. The illusion that the relationship between medicine and the drug industry is collegial, professional, and personal is carefully maintained by the drug industry, which actually views all transactions with physicians in finely calculated financial terms. Drug representatives are paid to be nice to us, as long as we cooperate, sustaining our market share of targeted drugs and limiting our continuing medical education lectures to messages that increase drug sales. This is an unspoken agreement, but no less clear for being covert.

The drug industry is happy to play the generous and genial uncle until physicians want to discuss subjects that are off limits, such as the benefits of diet or exercise, or the relationship between medicine and pharmaceutical companies. Any subject with the potential to reduce drug sales is anathema. Fair enough. He who pays the piper calls the tune. If we remain dependent on pharmaceutical companies for sponsoring continuing medical education, then these courses will remain under the control of the drug industry. This control is not contractual, but it is enforced through psychological manipulation."

Doctors are manipulated by pharma companies, like puppets - and sadly, it's the leading doctors ( the Presidents of Societies and Medical Associations) who connive with them to do so !

I like the clever solution he offers - read the article to find out what it is !

Teaching doctors about the games pharmaceutical companies play

Teaching doctors about the games pharmaceutical companies play : "Two weeks ago, armed with a $400,000 grant, Fugh-Berman and several Georgetown colleagues launched PharmedOut, a free, Internet-based alternative for doctors seeking CME courses devoid of industry funding. The site ( lists more than 200 online classes available to doctors at no cost, many of them sponsored by federal agencies such as the Food and Drug Administration and the National Institutes of Health. It also includes links to studies exploring the role of drug company funding in medical education and research, as well as a YouTube interview with a former drug salesman who candidly discusses the ways he deflected doctors' concerns about a widely prescribed psychiatric drug that has been linked to massive weight gain and diabetes.

PharmedOut is one of about two dozen projects across the country designed to teach doctors and nurses to critically evaluate information about drugs and to direct them to unbiased information. "

Watch the video if you want to learn how pharmaceutical companies dupe doctors !

Monday, January 22, 2007

Making PHRs work

Making PHRs work: "Right now, most individuals see PHRs as a lot of work with little benefit. Patients may input their diagnoses and medication histories, but few--if any--providers ever access them. If doctors begin using PHRs to interact with patients, however, consumers will get something out of them.

The Personalized Health Information Act would encourage doctors to use PHRs to replace the dreaded clipboards and multiple forms that patients face when they come to the doctor’s office. Any PHR could qualify for governmental incentives so long as it meets certain minimum standards. For example, the consumer needs to be in sole control over who has access to the record, a feature that will address many of the privacy concerns that often are raised by health IT. The data in the PHRs also will have to be fully portable, so that the individual can take the information with them to another provider at any time. In addition, PHRs will have to meet interoperability standards and privacy and security standards. Finally, the PHR must be able to send patient-specific messages in appropriate situations. Safeguards must be in place to ensure that absolutely no marketing or solicitations are permitted, and individuals must have the right to opt out of messages, either entirely or from particular sources, at"

wellness » Blueprint for an Integrated HIT system - The Patient Life-Cycle Wellness System

wellness » Blueprint for an Integrated HIT system - The Patient Life-Cycle Wellness System: "The Patient Life-Cycle Wellness System is an integral part of a rational healthcare system that delivers ever better and more affordable care through a collaborative, compassionate, knowledge-based effort that increases positive outcomes, minimizes errors and omissions, and ensures improvements in quality of care and patient safety. This approach recognizes the responsibility of all stakeholders in creating a sustainable healthcare that brings greater wellness to all in an effective and affordable way.

These HIT tools help drive a “cradle to grave” continuous improvement model for transforming the current reactive healthcare system — that operates on a “fix it and pay for it when it breaks” process — to a quality driven approach that includes:

* Proactive maintenance & preventions programs
* Personalized care supported by secure, economical, and useful health information technologies for exchanging patient data, studying clinical outcomes, guiding evidence-based treatment decisions, reducing errors and omissions, and assuring appropriate continuity of care for every episode of care
* Development of a sane payment system that encourages continuous quality improvement, while controlling costs and insuring everyone"

Hii Electronic Health Record System

Hii Electronic Health Record System: "The Hii™ Universal-Lifetime Electronic Health Record System is a longitudinal, interoperable, and multiprovider- and multidiscipline-based electronic health record system prototype. Its patented software architecture provides an easy and economical way to:

* Manage many millions of pieces of health data per person, coming from any number of sources, for a truly complete health record.

* Store the data in highly secure, virus-proof record-files, portions of which are accessible by authorized individuals anywhere and anytime, even as a patient moves through various healthcare settings.

* Provide extensive interoperability enabling patient health information to be exchanged among disparate clinicians and other authorized entities in real time and under stringent security, privacy and other protections.

* Use these data in conjunction with clinical decision-support software systems, helping to establish, deliver and evaluate evidence-based clinical pathways/guidelines.

* Support collaborative, peer-to-peer (decentralized) decision networks for sharing and discussing patients and approaches.

* Operate transparently and cost-effectively in existing IT systems while leveraging existing IT investments."

HealthNex: IBM Advocates for Patient-Centric Healthcare

HealthNex: IBM Advocates for Patient-Centric Healthcare: "'The will to create this patient-centric healthcare model is fundamental,' says McCulloch, 'but equally important is creating interoperable IT infrastructures that connect hospitals, agencies, research institutions — just about everyone who has a hand in shaping healthcare for individuals and populations.'

In lobbying for a transformation of the current U.S. healthcare system, McCulloch and IBM colleagues, such as Dr. Martin Sepulveda, vice president, Global Well-being Services & Health Benefits, begin their advocacy work by focusing on a problem that inhibits the development of a truly patient-centered model. One of IBM's recommendations is to create a reimbursement structure that primarily rewards providers for increasing patient health — instead of rewarding providers for seeing as many patients as possible, as is the case today."

Saturday, January 20, 2007

A holistic approach to customer satisfaction - keeping both doctors and patients happy !

A holistic approach to customer satisfaction - keeping both doctors and patients happy ! " A holistic approach to customer satisfaction Accenture teamed with Baptist Health in Montgomery, Alabama, to implement a redesigned
clinical information system (CIS). As an innovative solution in the electronic health records arena, Baptist Health’s new CIS makes use of wireless tablets and laptop computers. These devices can be transported into patient rooms and treatment areas, allowing medical personnel
to add or review data in real time. As a patient moves from one facility to another within the organization, the information flows with the patient. Today, all clinicians who add and review patient data—from nurses and admitting personnel to radiologists, lab technicians, social workers and, of course, physicians—make use of the new CIS. Physicians are saving time by accessing patient data wirelessly as they make their rounds."

spiked | Behind the IVF ‘trial by television’

spiked | Behind the IVF ‘trial by television’: "The Human Fertilisation and Embryology Authority (HFEA) claims that its investigations into IVF clinician Mohamed Taranissi – which have been splashed across the headlines this week – are part of its important regulation of IVF treatment in Britain. It even led raids on Taranissi’s clinic on Monday, in tandem with a BBC Panorama documentary ‘exposing’ Taranissi. However, spiked has learned that there is more to this than meets the eye, and that the HFEA has been curiously heavy-handed in its dealings with Taranissi, and possibly unprofessional in its dealings with Panorama.

Do we need public regulatory bodies empowered to make such decisions, or would we be better off scrapping the HFEA and developing something less bureaucratic instead?"

This is the problem with practising medicine today. Paperwork has become more important than taking care of patients; and bureaucrats are more powerful than doctors !

Draft EHR Anti-Fraud Requirements Available for Comment

Draft EHR Anti-Fraud Requirements Available for Comment : "Draft requirements for electronic health records that are intended to detect fraud and claims errors have been posted for public comment, Technology Daily reports (Technology Daily, 1/16).

The requirements are based on guiding principles established during an earlier phase of the project contract with the Office of the National Coordinator for Health IT, AHA News reports. Comments, which will be submitted to the Certification Commission for Health IT, are due on Jan. 22 (AHA News, 1/16)."

Giving it Away: E-Prescribing Initiative Boasts Free Web-Based Technology

Giving it Away: E-Prescribing Initiative Boasts Free Web-Based Technology : "Paper prescriptions could soon be an antiquated memory, an obsolete reminder of less efficient, more error-ridden days of health care yore. At least that's the hope of the National ePrescribing Patient Safety Initiative, which on Tuesday launched a program that will provide electronic prescribing to every physician in the U.S. at no cost.

E-prescribing for some time has been touted as a solution to errors from physicians' sloppy handwriting and adverse drug interactions. However, despite the potential of e-prescribing, adoption rates have remained low due to concerns ranging from cost to interoperability."

Improving the management of chronic illnesses at home with remote monitoring

Improving the management of chronic illnesses at home with remote monitoring : "1. Each day, in your own home, the Cardiocom TELESCALE, COMMANDER or CARESTAR
telemonitors your symptoms.

2. This information is automatically sent over your phone line to your doctor's
office in less than 30 seconds.

3. Your data is analyzed and your medical team is notified if you need help or
require a change in medication.

What can the COMMANDER, TELESCALE or CARESTAR do for you?

• Link you and your medical team daily.
• Alert your physician before problems occur.
• Prevent unnecessary hospitalizations.
• Decrease emergency room visits.
• Increase your confidence and independence.
• Improve your quality of life.

Cardiocom Home Telemonitoring Benefits

• Use every day in your own home.
• Links you directly to your doctor's office.
• Personalized, individual care"

What I like about this is that the patient is actively involved in managing his own disease - and can do this without leaving his home ! These tools help patients to become "expert patients" !

Winnowing the Web for medical news

Winnowing the Web for medical news: "The result is a Louisville startup, MedTrackAlert, that scours the online press for news of medicinal developments and then delivers the information to half a million newsletter subscribers. The service covers all of the major medications for chronic conditions and continues adding more drug coverage, he said."

This could tie in vry well with the PHR, because patients would know what informatoion they should be tracking, so the information stream they receive is customised for their needs.

Health Implications of EHRs - Accenture

Health Implications of EHRs " Patients obviously have strong emotional content as regards their own care but even more so the care of their loved ones. The personal health record (PHR) will increase the probability that the individual will become even more
involved in the choices to be made about themselves and their loved ones. Professionals providing that care have a deeper emotional commitment to their caregiving than may be found in almost any other field of human endeavor. Any activities that have direct or even indirect impact upon patient care cannot help but be seen through the lens of the human aspect of caring for people. "

I am impressed ! When talking about PHRs, Accenture is no longer talking about just the bottom-line, the cost saving or the ROI - they are talking about the human benefits of the PHR. I think this benefit ( emotional peace of mind) may well become the key catalyst for encouraging widespread adoption of the PHR !

Online Health Services - helping patients to manage their chronic illness at home

Online Health Services - helping patients to manage their chronic illness at home: "Almost 80 percent of health care spending in the United States goes to the care of chronic patients. Still, most doctors and nurses know little about what is happening to these patients in between their office visits. This lack of ongoing visibility often leads to patient suffering and costly emergency room visits. Thanks to recent technological developments, Accenture believes that promising solutions are on the horizon.

Accenture Technology Labs, Accenture's research and development (R&D) organization, has developed Online Health Services, a prototype that uses emerging technologies, such as wireless wearable and home health devices, to enable remote, continuous patient monitoring and proactive intervention. The prototype combines the latest advancements in the Labs' Sensor Telemetry and Information Insight R&D areas, which focus, respectively, on gathering sensor data from the physical world and analyzing it to improve outcomes, including better quality patient care and lower costs for healthcare providers and payers."

Thursday, January 18, 2007

Converting people into patients - a cautionary tale

I enjoy playing tennis, and had fun playing with a friend of mine who had come down from the USA . He is 30 years old and overweight, and because he hadn’t played for quite some time, I beat him comfortably on Saturday . He was raring to get revenge, so we fixed our next tennis date for Monday. On Sunday, however, he cancelled the match, saying his cardiologist had prohibited him from any strenuous exercise ! I was surprised , to say the least. Here was someone who’d had a great workout on Saturday – who was being forbidden from playing the next day by his doctor ! What had happened which had converted my healthy tennis partner into a patient ?

So I switched from my “tennis partner” mode to my doctor mode, and got the medical details. It turns out that because he was hypertensive, overweight, with a family history of heart disease and also had high cholesterol levels, his cardiologist in the USA had done a 64-slice cardiac CT for him to image his coronary arteries. These showed that two of them had a stenosis ( narrowing), which is why he had done to an Indian doctor for a second opinion on Sunday . This doctor had told him to get admitted on Monday for a coronary angioplasty, to treat the stenosis – and he was all set to do so, since this was such a “minor” procedure and would “fix “ his problem. So what’s the moral of this story ?

This guy is a smart MBA who is the CEO of a company, and it’s obvious that even smart people don’t behave very wisely when it comes to their own medical care. While he was very bright at tackling business problems and ran a multi-million dollar company very successfully , when it came to making personal medical decisions, he was quite content to leave everything upto his doctor – after all, “the doctor knows best” ! I am still not sure why intelligent people behave like this. While he would never ever blindly trust his lawyer or accountant , he just refused to do his “due diligence” when it came to his doctor’s advise – even though what was at stake was his entire life – not just a few dollars ! It’s fine to trust your doctor but verifying what he says is still a patient’s responsibility !

Because of the rapid advances in medical technology, it’s easy to take pictures of practically any part of the body – and doctors love doing this . Not only is looking at the pictures far more interesting than talking to patients – it’s also much more profitable ! The problem is that this leads to over testing and doctors routinely pickup abnormalities which are of no clinical importance – minor lesions which patients will carry to their grave without causing any mischief. However, once a lesion has been picked up, it’s a knee-jerk reflex to want to treat it – and once the medical behemoth has been set into motion, it’s practically impossible to stop it ! Few patients have the wisdom to question their doctor’s advise , with the result that few leave the medical maze unscathed and intact !

One of the results of this is that doctors end up treating the coronary angiogram – not the patient ! This is an easy ( and highly remunerative) procedure to perform , so that it’s done way too often. And while the benefits to the doctor are clear, few patients stop to ask how the procedure will help them ! So do these interventions really help ? Is it worthwhile “treating the narrowed artery “ Should the stenosis be “plumbered “ in an asymptomatic patient, with no complaints ? The sad fact is that no one really knows the answer to this simple question ! While the angioplasty will widen the narrowing ( at least for some time), no one knows whether it really helps in the long run ! Many of these “treated” arteries re-stenose in a few months, so whether the procedure helps or not is unclear. The end-point should not be a better looking coronary artery – it should be an improvement in life expectancy or a better quality of life. Since this has never been proven , most doctors are very happy to treat the narrowing on the “logical” basis that a widened artery is better than a narrowed artery. Sadly, most cardiologists today are just glorified plumbers – because that’s where the money is !

Key questions such as: What is the natural history of the stenosis ? What would happen if you left it alone ? Can it be reversed non-surgically with changes in lifestyle and medication ? What are the risks of the angioplasty ? are all left unasked and unanswered.

So why doesn’t the patient ask these questions ? This is because most doctors are very good at scaring patients into agreeing with them ! They congratulate the patient for seeking medical attention in “ the nick of time” so that they can save their hearts and their lives . They use fear tactics , create a sense of urgency ( which is completely unwarranted), thus precipitating the patient into taking action. Many of them warn the patient that the plaque which has caused the stenosis can ulcerate at any minute and lead to a heart attack , so that “ you may keel over and die any minute “ ! Imagine the amount of fear this creates in the patient – and his family members. They start treating him like a “time-bomb” which can go off any minute – and this is the exact same person who was working up a healthy sweat on the tennis court just 24 hours ago ! In reality, no one knows the natural history of these lesions – and doctors are not fortune tellers !

It’s very natural to want to do something – anything ! Most people are interventional by nature – “don’t just stand there – do something !” Many of these patients would have done equally well even without the angioplasty , but when they improve, they give all the credit to the doctor – credit which the doctor does not really deserve, but is happy to take ! And what of the ones who do poorly ? They attribute this to their fate – and some doctors even go so far as to suggest that this confirms that the patient was so sick that the complications would have been even worse if they had not done the procedure ! Patients are scared to death – and the doctor promises a lifeline they desperately want to cling on to.

The purpose of medicine is to help heal the ill – to convert patients to healthy people and restore them back to a purposeful life. Today, we seem to be doing exactly the opposite ! We seem to be converting healthy people into patients ! My friend has now become a “cardiac cripple”, who refuses to play tennis anymore – because his doctor won’t let him. In reality, physical exercise is the best therapy for ischemic heart disease, because it increase the blood supply to the heart – and improves the supply of blood to the heart tissue by promoting the development of collaterals ( the “natural bypass” which the body creates to deal with the stenosis). Stopping him from exercising is poor advise !

While doctors are meant to be professionals who are supposed to put the patient’s interests first , professionalism seems to have taken a back-seat today, because of commercialism . One of the world’s best cardiologists, Dr Lown, has documented this extremely well, in his marvellous book, The Lost Art of Healing.

Ivan Illich predicted that this would happen many years ago, in his classic, Medical Nemesis. The medical professional has medicalised nearly everything – ranging from simple activities like exercise ( “Please check with your doctor before starting an exercise regime”); to childbirth; and even dying. I can understand why doctors would want to do this – after all, the more power they have, the more they earn ! But why do average people allow them to get away with this abuse of power ?

This is not a healthcare system today – it’s an illness creating system ! And ironically, all our “ preventive medicine “ efforts today are devoted to this end – to suck more people into the system by doing “healthcare checkups” , thus converting them into patients
( because most of these tests will pick up some abnormality or the other – and the more the tests you do, the better the odds of picking up a problem ! Few doctors have the maturity to be able to reassure the patient that lots of these are minor variations, of no importance !) We have converted well people into the worried well !

So what’s the solution ? How do we put people in charge of their own healthcare ? How do we remind them that a doctor is just a professional who provides advise, and is not God ! The only solution is to empower them with information, so that they are empowered to make their own decisions. They need access to alternative viewpoints , and the pros and cons of all of these , at the point of use, so they don’t get browbeaten into doing what the doctor tells them ! Unfortunately, patients often feel powerless and helpless – and they are quite happy to let the doctor decide for them. While this can work well sometimes, it often doesn’t – and the buyer needs to beware !

An online personal health record can act as the nucleus of a patient networking system, where patients can ask for help from other patients – help which is likely to be much more authentic, since it comes from the “horse’s mouth” !

What of my friend ? Will he do the angioplasty ? I still don’t know. I just hope that some good will come of all this. Maybe the results of the scan will serve as a wake up call, so he spends some time on himself, and makes some healthy lifestyle changes. These are commonsense things to do , and these are what really help – not the surgery !

Wednesday, January 17, 2007

Initiatives in eHealth

Initiatives in eHealth: "In the analysis of our 2nd Annual Study on Initiatives in eHealth, one of the strongest findings is that there is a tremendous amount of activity in the healthcare web space today compared to previous years. This trend is no surprise, as more and more healthcare organizations are viewing the web as a tool to connect and engage health consumers, employees, physicians and payors simultaneously.

The distinguishing factor in the current wave of enhancement trends is the acknowledgement of the web as a strategically important component to organizations rather than simply a 'nice to have' ."

And as more doctors, clinics, hospitals and health insurance companies move online, it's just a matter of time that patients will follow !

Ernst & Young LLP Issues 2007 Outlook for U.S. Healthcare Provider Sector

Ernst & Young LLP Issues 2007 Outlook for U.S. Healthcare Provider Sector: "The healthcare sector lags behind other industries in its use of technology for business processes; especially notable is that only a small percentage of medical records are computerized. To spur progress in this area, there is growing support for the federal government to play a leadership role in establishing standards and funding. Before the 2006 mid-term elections, two competing health information technology (health IT) bills were passed, one in the House and one in the Senate, but no further action was taken in the 109th Congress, which ended with 2006. There is a good possibility that health IT proposals will once again emerge during the 110th Congress. Incoming Senate Health Committee Chairman Edward Kennedy (D-MA) has stated that one of his top priorities will be to pass health IT legislation."

Physicians Practice Articles : Patient Relations: No More, ‘Oh, By the Way…’

Physicians Practice Articles : Patient Relations: No More, ‘Oh, By the Way…’: ".. physicians must also learn to alter their perspective during exams, stepping back to let patients be patients. “We as doctors think our patients are not focused because they’re not giving us the information in the order we want it,” she says. “We’re thinking about chief complaints, medical history and treatment regimens, the things we were taught in medical school. But that’s not how the patient thinks. It’s not how you tell a story.”

Ventres agrees. At the end of the day, he notes, it’s all about taking time to meet your patients’ needs. “The biggest mistake physicians make is that they spend a vast majority of their time in the medical world, and they don’t communicate to patients in a way they understand,” he explains. “Regardless of the work we do, if a patient has no idea what we’re talking about, they may leave confused and that makes them less likely to follow the plan of action you’ve laid out.” "

Listen to the patient - please !

Listen to the patient - please !: "The majority of executives within healthcare are far too focused on the people inside the walls and are missing the trends on the outside. They are not listening to the health consumer – their customer. I hope to provide a clear voice to that end.

You see, I am “that patient” that you see in the statistics. I’m one of the 59% of U.S. adults who would like to communicate with their physician online, and I have changed doctors based on their willingness to communicate by email as 43% of Americans indicate an inclination to do. I am one of the 2/3 of Americans who care about hospital quality measures – I look at them and I understand what they mean.

In short, I am a health consumer who is “in-play” with the opportunity and the inclination to look at options for receiving care. So I hope that you will take what I have to say to heart.

You see, I can manage nearly every part of my life online. Why can't I manage my health too ? "

MedBilling Live - How It Works

MedBilling Live - How It Works: "Everything is totally automated once you provide us with the information we need to generate the bill. If you are using the Life Record EMR LivePractice Edition, everything is automatic. You do not do anything out of the regular visit. Once the patient visit is complete, the bill is generated and submitted via MedBilling Live. MedBilling Live works off the existing Life Record patient profile and all required information is utilized automatically by MedBilling Live to generate the bill and submit it to the payer. "

This makes so much sense !

MedBilling Live - Instant Medical Billing for your Practice

MedBilling Live - Instant Medical Billing for your Practice: "MedBilling Live is here to help. You can concentrate on providing healthcare and running your practice while we handle your billing.

Bill Anyone. Bill Anytime. Bill Instantly.
MedBilling Live can bill all healthcare plans including Medicare and Medicaid. Whether you are billing government based payers or private insurance companies - MedBilling Live can handle it. We take a different approach to billing. With HIPAA, insurance policies and medical billing practices changing all the time, you need a system that will change with them. All of our software is centrally hosted off of our servers. When a change comes down and needs to be implemented, you do not need to upgrade all of your computers or your software. We do it all from our servers and the end result is billing that 'just works' for you. No more paying a computer technician to install software, no more time out of your day to install upgrades. In fact, you won't even notice changes in most instances. "

One of the major hassles of running a medical practise today is collecting payment from the third-party payer. This sort of web-based real-time billing will help to improve a doctor's efficiency considerably ! And since it will impact the bottom-line, I guess a lot of doctors will adopt this. How to be a good patient, too How to be a good patient, too: "Part of being a smart patient is being a good patient. Show up (on time) for appointments, take medications (as prescribed), and fully disclose your history and habits to your doctor. But there's more.

Start a file. Collect copies of test results and imaging studies such as MRI s. Note the exact names, dosages, and timing of all your medications.

Call for test results. Don't settle for 'If you don't hear, you're fine.' Ask for your specific results and the values considered normal, and write them down. Request a copy.

Be your own scheduler. Patients don't always get reminders about regular screening tests or follow-up appointments. Call to ask when you're due to come in.

Keep your physician informed. If you think a medication is making your muscles ache or your stomach hurt, say so; side effects are not rare, and you can usually be switched to another drug. Make sure every physician knows about others you saw and tests and drugs that were ordered.

Spread good news. 'When things get better, we want to hear about it,' says Manhattan pediatrician Michel Cohen. -Katherine Hobson"

Excellent advise ! An online PHR will allow you to do all of this - and more !

DrScore :: improving patient care

DrScore :: improving patient care: "Ratings and comments submitted to DrScore are designed to give feedback to physicians to help them enhance their medical practice. DrScore is not a regulatory body and is not an appropriate venue for issues that need the attention of state or professional authorities."

However, I think there's just one problem with this.
Good doctors ( the ones who will check for patient feedback will most probably have good scores.)The bad doctors ( the ones with the poor scores who need to improve) will never check, because they don't care what their patients think of them !

The health checkup for hospitals !

The health checkup for hospitals !: "The annual health check provides a more detailed picture of how well organisations in the NHS are performing. This additional information means that we are now better able to answer some of the questions commonly asked by patients and the public, including:

* how safe and clean are healthcare services?
* how good is the care I will receive?
* how well is the organisation managed?"

This is a good guide for organisations who would like to implement a service which allows patients to judge how good their hospitals are.

Tuesday, January 16, 2007

The doctor will see you now -- online

The doctor will see you now -- online: "He began the virtual office visits in late December, allowing established patients to submit medical information via his Web site and potentially avoid having to take time off work for a simple cold or cough.

Patients answer a series of 'drop-down' menu questions about their symptoms and submit them to the doctor online. The doctor then either prescribes a medicine or asks the patient to come in for an office visit.

It's not free -- the patients are still charged an insurance co-pay."

iCONSULT - Products

iCONSULT - Products: "iCONSULT is the 'connector' that integrates our clinical reference content with your EHR. iCONSULT uses information directly from the patient record to select relevant information, without the need to log in, run searches, and scan through long lists of hits."

Add-on products like this are what are going to make EMRs so useful for doctors. So far, the EMR has just been a digital alternative to the paper medical record. Clinical decision support systems such as iCONSULT are a major value add, because they enhance the value of the EMR by offering useful customised relevant information to the doctor at the time he is entering the data into the medical record. Information at the point of use is a potential killer app !

Intelligent Medical Objects

Intelligent Medical Objects: "MO's Personal Health Terminology (PHT) is a suite of vocabulary products that help people manage their health information. IMO's robust, user-friendly vocabularies contain user-specific and familiar words and phrases, allowing clinicians, information management professionals, and patients alike to find and record the terms they need quickly and easily. PHT's crosslinks to standardized vocabularies such as MeSH, UMLS and SNOMED® CT help to easily connect providers and patients with the patient record, administrative information, academic references, and consumer information. Health care professionals can focus on patient care, while IMO provides connectivity to decision-support, billing and information for them and their patients.

Most importantly, IMO's PHT allows health care organizations and software developers to focus on the work that they need to do and not worry about creating and maintaining their own health data dictionaries."

These clever tools can help patients to make sense of the medical jargon in their PHR !

The Medical Banking Project

The Medical Banking Project: "The Medical Banking Project drives lower healthcare costs by researching and facilitating cross-industry models that optimize banking resources for healthcare. Established in May 2001, MBProject consolidates pro-bono, educational and commercial activities initiated by our founder. We are defining the “medical banking” industry through internal research and continuous cross-industry outreach forums."

This is a clever idea ! How can we piggyback on the excellent infratructure banks have set up in order to improve healthcare services ?

Medical Banking Project to focus on personal health records

Medical Banking Project to focus on personal health records: "The Franklin, Tenn. -based Medical Banking Project is a policy research, strategic advisory and industry action group that seeks to promote integration of healthcare and banking systems.

The personal health record initiative would aim to work with the growing number of regional health information organizations, Casillas said. The Medical Banking Project wants to pioneer the idea of a bank-driven “medical Internet” that can work with RHIOs and other market structures to accelerate the adoption of electronic and personal health records, he said. "

Web service offers easy access to health records

Web service offers easy access to health records: "In Congress last month, Rep. Patrick Kennedy, D-R.I., introduced a bill to give physicians a $2 incentive for each patient of theirs who creates a personal health record. A study by the Institute of Medicine and the Institute of Healthcare Improvement said the use of technology and personal health records could put the U.S. on a path to reduce the mortality rate by 25 percent."

If doctors are given financially incentives to create PHRs for their patients, this will be a major catalyst in ensuring a high level of PHR penetration !


PassportMD: " * A 10 minute 'Start to Finish' Wizard creates Your PHR
* We don't ask for your Social Security Number
* Easy to read text and forms
* Unlimited Access. Works with all Doctors' Offices

Why wait until...

* A new doctor needs your old records
* A child gets sick traveling away at summer camp or at college
* A medical emergency occurs while traveling on a cruise
* A parent is hospitalized & you need to find their living will
* A natural disaster strikes home & you need files for insurance claims ? "

Where's your PHR ? And why don't you have one ?

Social-Networking Sites Let Patients, Providers Share Data

Social-Networking Sites Let Patients, Providers Share Data : " Health care Web sites provide virtual communities that let patients share information on treatment and coping and allow advocacy groups, government agencies and health care providers to inform consumers about relevant health news, the Wall Street Journal reports.

One Web site, called, allows patients and providers to join support communities, start a wellness journal, share advice, recommend physicians and link to Web sites that contain disease information. "

BBC NEWS - GP launches YouTube health films

BBC NEWS - GP launches YouTube health films: "A GPs' surgery in mid Wales has launched a series of health education films on YouTube, better known as a website featuring home videos. Advice about flu vaccination and cervical screening are two of the topics covered by Builth and Llanwrtyd Medical Practice in Powys.

Doctors said they wanted to help educate their 7,700 patients and a wider global audience."

Clever doctors are using clever tools to educate their patients !

Social-Networking Sites Let Patients, Providers Share Data

Social-Networking Sites Let Patients, Providers Share Data : " Health care Web sites provide virtual communities that let patients share information on treatment and coping and allow advocacy groups, government agencies and health care providers to inform consumers about relevant health news, the Wall Street Journal reports.

One Web site, called, allows patients and providers to join support communities, start a wellness journal, share advice, recommend physicians and link to Web sites that contain disease information. "

BBC NEWS | UK | Wales | Mid Wales | GP launches YouTube health films

BBC NEWS | UK | Wales | Mid Wales | GP launches YouTube health films: "A GPs' surgery in mid Wales has launched a series of health education films on YouTube, better known as a website featuring home videos. Advice about flu vaccination and cervical screening are two of the topics covered by Builth and Llanwrtyd Medical Practice in Powys. Doctors said they wanted to help educate their 7,700 patients and a wider global audience."

Clever doctors are using clever new tools to educate their patients !

Benefits of the EHR

Benefits of the EHR: "The Electronic Health Record is globally accepted as a necessity:

* to better meet patient expectations,
* to expedite many tedious work processes such as prescription writing and creation of chart notes, service administration, research, planning and audit, communication between patients and providers, fiscal governance
* to create new ways in which the health of our patients can be improved
* to improve cost efficiency due to raising demands of healthcare and the aging population
* Portability – travel, second opinions, emigration, working abroad, distant working and support for developing countries and as part of aid, war, famine and assistance to refugees While professional experience with the EHR is generally positive, there are even more opportunities for improving care with the EHR once patients have access to their own records.

Evidence-based benefits include:

* Improving the relationship between clinician and patient
* Improving trust between patient and clinician
* Practical support for patients in managing their health
* Improving compliance
* Patients feel empowered to make decisions about their health?
* More efficient use of consulting time"

How EHRs help patients - a view from the UK

How EHRs help patients - a view from the UK "It is evident that a Shared Electronic Health Record has many advantages over the traditional paper record. Unlike the traditional paper record it is patient-centred and enables patients and their clinicians to put the health record to much wider use.

It cannot be overstressed that the prime function of the Electronic Health Record is to give a higher level of support to patients and to enhance the quality of health care they receive. A shared electronic record will have fewer errors since the one person present at every consultation and medical encounter - the patient - has the opportunity to see and check the accuracy of the details included on the record.

If given free access to their complete Health Record patients become enabled to take a greater part in the management of their own health. "

Monday, January 15, 2007

Consumer's Tool Kit for Health Care Advance Planning - Commission on Law and Aging

Consumer's Tool Kit for Health Care Advance Planning - Commission on Law and Aging: "If you are looking at this tool kit, you are either thinking of making a health care advance directive (such as a living will or durable power of attorney for health care), or you may have already signed one. In either case, you should be aware that just having a written advance directive by itself does not ensure that your wishes will be understood and respected. Studies have shown that standard advance directive forms do little to influence end-of-life decisions without: 1) informed, thoughtful reflection about your wishes and values, and 2) personal communication between you and your likely decision-makers before a crisis occurs.


Good advance planning for health care decisions is, in reality, a continuing conversation - about values, priorities, the meaning of one's life, and quality of life. To help you in this process, this tool kit contains a variety of self-help worksheets, suggestions, and resources. There are 10 tools in all, each clearly labeled and user-friendly. The tool kit does not create a formal advance directive for you. Instead, it helps you do the much harder job of discovering, clarifying, and communicating what is important to you in the face of serious illness."

Sunday, January 14, 2007

Medical complex gives retail a shot - Los Angeles Times

Medical complex gives retail a shot - Los Angeles Times: "Will patients visiting their medical center for a CT scan or a flu shot also stay for lunch or some shopping? Thomas LeBeau thinks so.

The Newport Beach developer is building a $50-million project in Fullerton that will be part doctors' offices and part shopping mall — one of a growing number of such medical complexes in Southern California.

In LeBeau's vision, patients would come for medical appointments and perhaps meet a friend for lunch or browse for skin-care products. To encourage browsing and eating, the doctors' offices will have small waiting rooms and patients will be given pagers that alert them when the doctor is ready to see them."

Plan for the effects of consumer-driven care --

Plan for the effects of consumer-driven care -- : "Keep in mind that HSAs are just one indicator of a larger sea change in healthcare--an unmistakable shift from a “doctor-knows-best” to a consumer-driven patient mentality. Whether patients give your front-desk staffer a traditional $15 copay or hand over a credit card, check, or promissory note to cover a larger balance, they’re going to have higher expectations than the clientele of 20 years ago.

In other words, they don’t want to know just how much they’re paying, but also what they’re paying for."

And clever doctors will find ways of letting patients know - so they can build up a loyal patient base !

The James Lind Alliance - tackling treatment uncertainties together.

The James Lind Alliance - tackling treatment uncertainties together.: "Research on the effects of treatments often overlooks the shared interests of patients and clinicians. As a result, questions they both consider important are not addressed. For example when patients, rheumatologists, physiotherapists and general practitioners were asked to identify their priorities for research on the management of osteoarthritis of the knee, there was little enthusiasm for the studies of drugs that the pharmaceutical industry typically supports. Instead, patients and clinicians wanted more rigorous evaluation of the effects of physiotherapy and surgery, and better assessment of the educational and coping strategies that might help patients to manage this chronic, disabling and often painful condition.

The pharmaceutical and medical technology industries and academia play an essential role in developing new treatments. However, the priorities of industry and academics are not necessarily the same as those of patients and clinicians. For this reason many areas of potentially valuable research are neglected.

Furthermore, it should not be assumed that patients and clinicians will always have the same research priorities, unless a process to assess these priorities – like that used for osteoarthritis - has shown that they do. The James Lind Alliance has been established to encourage and facilitate such a process."

This is such a great idea - give patients what they want and what they need !

Myths About Patient Involvement

Myths About Patient Involvement " The perception of patients as lacking the basic skills to be trusted with any real power or influence in the health service, is linked to the perception of empowered patients as “atypical” and therefore not to be taken too seriously. Patients are no more and no less intelligent than the general population, since we are the general population: we are, when not wearing a hospital gown, parents, teachers, lawyers, builders, policemen, and plumbers.
We are apparently responsible enough to decide whom to marry, whom to vote for, where to live, and whether or not to have children. Surely we can be trusted to participate in healthcare policy too, and at a level above that of menu choices and d├ęcor decisions. If we lack anything, it is not intelligence or judgement, but training and information. That can and must be provided."

This is a refreshing breath of fresh air from an articulate and well-informed patient ( may their tribe increase !)

The patient is not a fool - she is your wife !

Involving patients

Involving patients : " Any service improvement will require input from a number of different groups: for example a project to improve waiting times in the clinic will involve doctors, nurses, receptionists and, of course, patients and carers. Each group will have a different perspective and different experience and expertise to bring to bear on the topic. The overall reason to involve patients and carers is, of course, to get their experience and expertise to enrich the solution."

Why involve consumers in health care ?

Why involve consumers in health care ? " Poor practice in healthcare can undermine consumers’ confidence in providers, and mistakes can potentially lead to long-term disability or death. For these reasons,healthcare is a high-profile consumer issue. And recent cases of bad practice covered by the media have led to growing public concern about protection for patients in both the public and private sectors. But, it is often difficult to find out what systems there are for protecting consumers because the regulatory and self-regulatory systems
for healthcare are complicated. Consumers may also find it difficult to access and use complaints and disciplinary procedures when things go wrong. When a profession is both regulated and promoted by the same body, conflicts of
interest may occur. This problem can be resolved in part by greater openness and more involvement of people representing the consumer interest."

Design of health information

Design of health information: "The influence of the graphical design of health information, regardless of the medium, is as important as the role of the content in producing something accessible, usable and meaningful for patients and the public. Good design can also help you to:

* Present your audience with a consistent message about who you are and what you are all about
* Inspire confidence and trust in you and your organisation
* Give the same message in a number of different ways to help you reach different audiences
* Take the patient on a journey through a subject where the content flows and has meaning and which ends with understanding"

Establishing and running information services

Establishing and running information services: " Raising awareness of the role and contribution of health information centres and services in improving the patient experience
# Sharing knowledge and best practice on the establishment and development of health information services
# Methods of involving patients and the public to ensure health information services best meet their needs"

Sourcing health information

Sourcing health information: " Pointers to finding the health information you are looking for, whether you are looking for information for yourself, a relative or friend; are a healthcare or information professional needing to guide someone to a suitable source of information, or want to find up to date evidence on which to base a new information product."

Toolkit for producing patient information

Toolkit for producing patient information It's often hard to produce patient educational material which is readable and patient-friendly. This valuable guide is full of useful gems and tips !

Information about electronic health records and the iHealthRecord

Information about electronic health records and the iHealthRecord: " By investing just a few minutes to create an iHealthRecord, you can feel confident that you'll have comprehensive health information for you and the ones you care for (your spouse, children, parents or other loved ones) whenever you may need it. The iHealthRecord is a secure and confidential interactive record that allows you to store, update and share health information with your physician or in an emergency situation."

What is very clever about this model is that they are making the PHR available free to patients through physicians. The iHealthRecord is already widely available today on 100,000 physician web sites. This is a clever way of creating a win-win situation and encouraging both doctors and patients to invest in a PHR !

Technology helps patients take charge of health records -

Technology helps patients take charge of health records - "While you can retrieve cash from your bank account anywhere in the world and maintain your bank records online, Americans seldom maintain their health records by using software, hardware and Internet connections.

This is because the medical system has lagged in using information technology. Only an estimated 10% to 20% of U.S. hospitals and physician offices maintain fully computerized patient records.

But with many of us taking a greater interest in our health care — partly by researching health information online — some experts believe the time is ripe for patients to create their own electronic personal health record, also called a PHR.

Advocates say it's a new way to take your health in your own hands.

A PHR is a comprehensive record that you own, control and maintain over time. You decide when to share its contents — in response to a doctor's inquiry or because you think there is something more a doctor needs to know about your health history.

Your personal health record should be electronic, easily portable, private and secure."

Friday, January 12, 2007

HealthCapture PHR

HealthCapture PHR: "HealthCapture PHR™ is your personal health record management tool. The WYSIWYG (what you see is what you get) editor gives you a friendly environment to view or edit your healthcare information. The Access Control Manager feature, allows you to select who may or may not access your personal information. Your HealthCapture PHR™ securely protects your healthcare data and gives you a variety of options to share your PHR information, including transporting your PHR on a portable electronic device (e.g. USB Jump Drive, CD, etc.), or sending via secure Email, and of course the option to print your HealthCapture PHR™ to paper."

Networked PHRs as tools for transformation

Networked PHRs as tools for transformation" This paper argues that consumers can help accelerate transformative change, particularly in a networked information environment. However, we emphasize that clinicians also have a critical
role in realizing the full potential of networked PHRs. Consumers continue to see doctors and other health professionals as the key agents of their care and the most trusted hosts of their personal health information. To take advantage of networked personal health information, both consumers and clinicians must be open to changes in their relationships, responsibilities, and workflows. Network-enabled efficiencies and safety improvements are more likely to occur if consumers and health care professionals act as partners who share access to and responsibility for updating personal health information."

Google Health - Connecting Americans to Their Health Care

Google Health - Connecting Americans to Their Health Care:
Empowered Consumers, Personal Health Records
" But more importantly, every ill person needs a “health URL,” an online meeting place where their caregivers — with express permission from the ill person — can come together, pass on notes to each other, review each other’s notes, look at the medical data, and suggest courses of action. This isn’t rocket science. It is online web applications 101. And it would have helped in so many other ways."

This is what a PHR is !

When Google talks, we should all listen !

CCR Standard -- AAFP Center for Health Information Technology

CCR Standard -- AAFP Center for Health Information Technology: "The ASTM CCR standard is a patient health summary standard, a way to create flexible documents that contain the most relevant and timely core health information about a patient, and to send these electronically from one care giver to another. It contains various sections -- such as patient demographics, insurance information, diagnosis and problem list, medications, allergies, care plan, etc. – that represent a “snapshot” of a patient’s health data that can be useful, even lifesaving, if available when patients have their next clinical encounter. The ASTM CCR standard is designed to permit easy creation by a physician using an electronic health record software program (EHR) at the end of an encounter.

Because it is expressed in the World Wide Web standard language known as XML, the CCR can be created, read and interpreted by various EHRs from various software companies. The ability to share information across different software is known as “interoperability.” "

New healthcare record standard

New healthcare record standard: "A revolutionary new ASTM International standard will change the way in which healthcare professionals preserve and transfer healthcare information about their patients. The standard, E 2369, Specification for Continuity of Care Record (CCR), was developed by Subcommittee E31.28 on Electronic Health Records, which is under the jurisdiction of Committee E31 on Healthcare Informatics. The Continuity of Care Record is a core dataset to be sent to the next healthcare provider whenever a patient is referred, transferred, or otherwise uses different clinics, hospitals, or other providers. The CCR will bring an end to physicians and other healthcare professionals having to act 'blindly,' without easy access to relevant patient information. It will provide the necessary information to support continuity of care, thus reducing medical errors, achieving higher efficiency, and creating better quality of care."

Electronic Health Record Project to Improve Quality, Safety and Efficiency of Medical Care -- American Academy

Electronic Health Record Project to Improve Quality, Safety and Efficiency of Medical Care -- American Academy of Family Physicians: "“We at the American Academy of Family Physicians (AAFP) have agreed to participate in a pilot project in which patient-authorized, secure and appropriate patient health information will be exchanged between MinuteClinic, Inc., sites and family physicians’ practices.” “The project will utilize the Continuity of Care Record standard (ASTM CCR E2369-05) to assure portability and interoperability of personal health records provided to patients who visit MinuteClinic convenience care clinics. It will field test the CCR standard in family physicians’ offices, as well as in MinuteClinic sites where nurse practitioners and physician assistants provide care. The field test will occur in several markets as a prelude to a national roll out. "

With these new standards, it'll be much easier for the chemist, medical lab, doctor, hospital and health insurance plan to share information about the patient - all of which can be fed into the patient's own online PHR !

Tutorials -- AAFP Center for Health Information Technology

Tutorials -- AAFP Center for Health Information Technology: "These tutorials will give you basic information about how to prepare your practice for an EHR, select the right one for you, redesign your office workflow, and maintain and improve how the EHR works for you."

An excellent guide for doctors who want to use EMRs for their practise.

CORE initiative blazes path for information exchange --

CORE initiative blazes path for information exchange -- "The electronic data exchange days will soon be here. The Coalition for Affordable Quality Healthcare, a nonprofit alliance of health plans, provider networks, and trade associations, announced in September that more than 20 leading healthcare organizations have committed to abide by rules created through its Committee on Operating Rules for Information Exchange initiative.

Those communication rules will allow providers to confirm patient eligibility and benefits electronically with real-time replies."

Center for Health Transformation

Center for Health Transformation: "Healthcare Consumerism is about transforming a health benefit plan into one that puts economic purchasing power—and decision-making—in the hands of participants. It’s about supplying the information and decision support tools they need, along with financial incentives, rewards, and other benefits that encourage personal involvement in altering health and healthcare purchasing behaviors."

Getting health-care field wired

Getting health-care field wired: "Physicians and other health-care providers are eager to use health information technology. According to a physician survey by Manhattan Research, 99 percent of doctors surf the Web, 95 percent use search engines to find medical information, and 90 percent have a high-speed Internet connection. The sad reality is that most physicians put down their laptops and pick up their clipboards when they walk into a patient's room. For the health of our citizens and the future of our country, that's a reality we must change."

Screen All Pregnancies for Down Syndrome, Doctors Say - New York Times

Screen All Pregnancies for Down Syndrome, Doctors Say - New York Times: "But now the American College of Obstetricians and Gynecologists is recommending Down syndrome screening for all pregnant women, regardless of their age."

I think this is overkill ! I can understand how it would benefit all gynecologists ( more work for them to do , and more fees to charge !); but I am not sure how helpful this would be to pregnant women. What about the emotional cost of worrying about false positive results ? What about the trauma caused as a result of terminating normal fetuses because of an inaccurate report ? Why aren't these being considered ?

Doctors and patients - differing perceptions !

Doctors and patients - differing perceptions ! " Almost 40 percent of patients researched their medical conditions online. But 41 percent of doctors surveyed said their patients often showed up poorly informed because of bad information found online."

Patients are going to keep on looking for information, and unfortunately they cannot judge the quality of what they find. This is why doctors should help them in their quest for information by putting up their own websites, and guiding them to reliable sources ! Patients would much rather trust the information their doctors gives them - and the only reason they are forced to go online is because their doctor is not helpful.

Tuesday, January 09, 2007

Embryo adoption - The Hindu News Update Service

Embryo adoption - The Hindu News Update Service: "Embryo adoption is the newest method of family-building, whereby childless couples instead of adopting a baby, adopt an embryo.

This is different from surrogacy where a woman carries a pregnancy for the benefit of the infertile couple. In embryo adoption, the child that the couple carries is the child that they will parent."

Sunday, January 07, 2007

IVF and the fear of failure - what IVF patients can learn from entrepreneurs

Many infertile couples know that IVF represents their best chance of getting pregnant. However, many of them are scared of doing IVF, because of their fear of failure. They are afraid that the IVF cycle may fail, and they don't think they will be able to cope with this failure.

This fear is very similar to the fear many employees have when they think about becoming an entrepreneur and starting up their own company. Sure an IVF cycle can fail, just like a startup can. But if you don't make the attempt, you'll never succeed ! And what's the worst which can happen ? You may not succeed. But at least you have the peace of mind of knowing that you gave it your best shot !

And just like some people become excellent serial entrepreneurs, and find it much easier to start their next company, many infertile couples find it much easier to start their 2nd and 3rd IVF cycle because they have more realistic expectations !

Here are the lessons I feel infertile couples doing IVF can learn from entrepreneurs.

1. Be as well-informed as you can. Do your research , read books, check out websites, and meet doctors. Knowledge is power, and being curious and well-read will help you in your decision making process. You are the CEO – you need to ask for input, but you’ll need to make your decisions for yourself !

2. Build a great team. IVF is a complex process, which requires high-tech medical expertise as well as tender loving care. You cannot do this alone, and finding a doctor you are comfortable with is a very important decision you will need to make.

3. Doing IVF can be a lonely road and few people will understand what you are going through. Entrepreneurs are solitary beasts, who march to the tune of a different drummer – and you’ll find that few fertile couples can understand the angst you are going through. Trust your instincts !

4. Build a support network . This can often spell the difference between happiness and distress. You can find this in the real world – or online. Remember, that you are not alone – and others can help you along your path.
5. Make a plan – and be prepared to modify it. A “business plan “ can help you cope with the ups and downs of IVF. Failure is never final. You need to learn from it and move on. Learning to fail forward is key.

6. Yes, IVF is a risky enterprise. Just like most startups will fail, most IVF cycles will fail too. However, the rewards are worth it, so it's well worth making the effort Life can be unfair, and just like no one can predict which startup will succeed, and which won’t, the same uncertainty applies to IVF as well !

7. This is a well-kept secret, but the risks of not trying are actually far more than the risks of trying and failing. Build an an exit option. Know when to stop trying and to move on.

8. Have a backup plan. Life is unpredictable, and you never know where it will take you. If your cycle fails, what will you do next ? Just like all successful entrepreneurs need to plan for the possibility of failure, you need to do so too !

9. Be kind to yourself ! IVF can be very stressful – and you need to learn to look after yourself and your personal needs. A startup can be as demanding as an IVF cycle, but if you don’t look after yourself, no one else will do so – and you need to be in good shape, both mentally and physically, to be able to give it your best !

10. Being an entrepreneur, just like being infertile, changes you as a person. It tests your resilience and your character - and can bring out the best in you - and the worst as well.
There will be major ups and downs - but the ride can be very exciting ! You need nerves of steel, and the heart of a lion. Outcomes are always uncertain, when you start a company or an IVF cycle, but the process should always be a positive one !

And finally,

11. Find funding. It's an expensive proposition , so make sure you don't run out of
money !

How to Communicate Constructively

How to Communicate Constructively: "Complete messages include four components:

Observations: neutral statements of fact
Thoughts: your own opinions and beliefs
Feelings:descriptions of your emotions
Needs: a statement of what you need or want from the other person"

Most doctors simply hear the patients observations and then try to jump to a diagnosis and treatment plan. They are bent on "fixing the problem". They need to stop and think about what the patient's underlying needs are, so they can fulfill these. Until they do this, they will not be able to take good care of their patients.

Unfortunately, many patients are not good at articulating their feelings - or their needs. You need to be able to ask questions cleverly in order to find out what these are. Being curious about your patients helps !

Effective Listening

Effective Listening: "There is a real distinction between merely hearing the words and really listening for the message."

Doctors need to learn how to listen - and also be able to demonstrate to the patient that they have truly understood !

HealthFrame - Personal Health Record Software - iPod

HealthFrame - Personal Health Record Software - iPod: "With the click of a button, HealthFrame™ users can transfer to their iPods emergency contact information, provider and medication lists, known allergies, and other pertinent health-related information, including attachments.
There are a number of advantages to using your iPod to carry your medical information:

* Exchanging information with medical and wellness providers’ computer systems
* There is no need to install or launch any software programs – doctors can view your information directly from the iPod's screen.
* Providers need not fear infecting their computer systems with viruses since the personal health record does not need to be downloaded.
* Your iPod has enough storage to hold your entire medical information- you do not need to buy or carry a new device with you.
* Using HealthFrame™ to synchronize your medical records to your iPod is a non-intrusive, creative way of making sure you have your health record with you, at all times.

HealthFrame™ is the only commercially available personal health record that helps you use your iPod in support of your wellness, health and emergency care."

Clinical decision support

Clinical decision support "Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate
times, to enhance health and health care. It encompasses a variety of tools and interventions such as computerized alerts and reminders, clinical guidelines, order sets, patient data reports and dashboards, documentation templates, diagnostic support, and clinical workflow tools. "

TEPR 2007

TEPR 2007: "The 23rd Annual TEPR - Towards the Electronic Patient Record -- Conference & Exhibition will take place May 19-23, 2007 in the Dallas Convention Center, Dallas, Texas. Dallas' slogan is “Live Large. Think Big,” and planning is underway to make TEPR 2007 the biggest and best TEPR ever.

TEPR is recognized as the best annual educational conference and exhibition for health IT professionals and all others journeying Towards the Electronic Patient Record."

Synergies between technology and healthcare experts.

Synergies between technology and healthcare experts.: "Most people who have managed, administered, or used healthcare software have been frustrated by the gratuitous complexity and poor quality that comes with an outrageous price tag. It doesn't have to be this way. We succeed where others fail because we're a new kind of healthcare software company. We consistently use sound engineering principles not only to create software, but to diagnose problems and find solutions.

It is a fact of life that technical people and healthcare people tend to approach things very differently and think differently. Technical people are usually more comfortable with strategic thinking, while healthcare people are usually more comfortable with tactical thinking. This makes productive communication very difficult. The common outcome is that technology is used not to solve problems, but to automate existing ones. We believe the best way to handle this diversity is to have people with a foot in both camps: software developers steeped in real-world healthcare workflow modeling, and physicians and other healthcare professionals who are avid technology enthusiasts. When you get these type of people together, the excitement is almost palpable as ideas interact and build on one another. These people are not easy to find, but it's amazing how few people are needed when interactions are synergistic and mutually reinforcing instead of destructive. "

Clever new ways and clever new people can team up to solve age-old problems !

Saturday, January 06, 2007

BubblePLY - making video annotation child's play !

BubblePLY - making video annotation child's play : "Add Bubbles to any video, Post it anywhere you wish!"

This is so cool - and so clever ! It would be a great educational tool as well ! For example, if you wanted to teach children English, it's now become extremely easy for anyone in the world to add English subtitles to an English film. Since the technology is so easy, thousands can contribute their efforts !

I am sure Google video is going to buy these guys out soon :)

Health consumerism | The wellness boom |

Health consumerism | The wellness boom | "There is growing evidence that focusing holistically on wellness can reduce health-care costs by emphasising prevention over treatment. Mr Case reckons that one of the roots of today's health-care crisis, especially in America, is that prevention and care are not suitably joined up. A growing number of employers now promote wellness at work, both to cut costs and to reduce stress and health-related absenteeism, says Jon Denoris of Catalyst Health, a gym business in London. He has been helping the British arm of Harley Davidson, a motorbike-maker, to develop a wellness programme for its workers.

The desire to reduce health-care costs is one force behind the rise of the wellness industry; the other is the growing demand from consumers for things that make them feel healthier. "

Finally, healthcare will become an industry which looks after your health, rather than one which taks care only of ill patients !

Detroit Medical Center - Money Back Guarantee

Detroit Medical Center - Money Back Guarantee: "The only hospital system in America with a money back guarantee. If our patients are not absolutely satisfied with any aspect of their inpatient service or overnight stay in a DMC hospital, we will credit their patient pay balance up to $100. "

This is called putting your money where your mouth is ! DMC is showing the healthcare industry how it can really become a service industry !

29 Minute ER Guarantee

29 Minute ER Guarantee: "At the Detroit Medical Center, we get you home before others get you in. We guarantee that you will see a DMC emergency doctor in 29 minutes or less. We've revolutionized the Emergency Room process, to ensure faster access to the finest care in southeast Michigan."

This is a great service to offer ! I think they have set a new benchmark - and if they can do it, other hospitals can learn from their experience and implement their processes to offer a similar standard of service to their patients. I hope doctors will start providing a similar service too ( if you are not seen within 30 min of your scheduled appointment time, the consultation is free !)

Why health informatics is the basis of all healthcare

Why health informatics is the basis of all healthcare: "We tend to think of health information technology (HIT) primarily in terms of EMRs, PACS, and billing and coding software. These kinds of HIT are a necessary focus of interest, given that providers are so far behind in using them. But there is more to HIT than EMRs and PACS.

According to the Office of the National Coordinator for Health Information Technology (ONC), health information technology is “the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing and use of health care information, data and knowledge for communication and decision-making.”

This means that everything from a gene bank to an implanted biomonitoring sensor is an HIT. "

Hospital Report Cards - promoting transparency

Hospital Report Cards - promoting transparency: "Oregon Health & Science University supports easy access for healthcare consumers to current hospital information. Our commitment is to accurately report about the safety, quality and level of patient satisfaction related to the care we provide in our hospitals and clinics. This Web site provides access to online resources and explanations about the data that is provided. We hope this information is helpful in your evaluation of healthcare services.

As healthcare providers, educators and advocates for safe, quality care we think this type of transparent reporting is essential to our community."

10 patient safety tips for hospitals

10 patient safety tips for hospitals " Medical errors can occur at many points in the health care system, particularly in hospitals. The Agency for Healthcare Research and Quality (AHRQ) has funded more than 100 patient safety projects since 2001. Many of the findings can immediately be put into practice in hospitals by following 10 simple tips."

Expert Teams to Design New Solutions for Personal Health Records to Help Consumers Manage Their Health

Expert Teams to Design New Solutions for Personal Health Records to Help Consumers Manage Their Health: "The Robert Wood Johnson Foundation (RWJF) today kicked off a landmark program to design and test bold ideas for how consumers can use information technology to better manage their health and navigate the health care system.

Project HealthDesign: Rethinking the Power and Potential of Personal Health Records, a $4.4 million initiative, has selected nine multidisciplinary teams that will build new tools that advance the field of personal health record (PHR) systems. The teams were chosen from a pool of more than 165 applicants and each has been selected to receive an 18-month, $300,000 grant.

"It's not just the wider use of personal health records or online access to the data they store that is so revolutionary," said Stephen Downs, S.M., RWJF senior program officer and deputy director of the Health Group. "Project HealthDesign is challenging the PHR field to focus on the potential for patients, providers and caregivers to use this information to improve their health. The design of the systems over which this information flows is critical, and that is why we're excited to support the efforts of these technology pioneers to develop the next generation of PHR systems."

With so many clever people working on PHRs, I think we are going to see some very interesting developments in this field !

Friday, January 05, 2007

Personal Health Record LifeSensor®

Personal Health Record LifeSensor® : "LifeSensor bridges the communication gap between members of your health team by sharing accurate and up-to-date health information from different care settings in one view. This enhanced communication improves communications between healthcare professionals and you, resulting in improved quality of care and patient safety.

LifeSensor gives you the ability to assume greater responsibility for your self-care. Not only can you monitor and track data about your health on a regular basis, such as blood pressure, weight, or blood glucose levels, but also this vital information can be automatically uploaded from your monitoring device into your health record for real-time analysis and treatment intervention by your healthcare team.

Your electronic Personal Health Record enables you and your physician(s) to work together towards good health: Confidentially, Securely, and Reliably, Anytime, Anyplace"

Encouraging doctors to use an EMR by offering PHRs to patients

Encouraging doctors to use an EMR by offering PHRs to patients: "“What is new in all this,” said Jessee, “is the idea of encouraging consumers to create their own PHR as a ‘pull-through’ strategy to get more physicians to use EHRs that can interface with those PHRs."

Thursday, January 04, 2007

What’s Making Us Sick Is an Epidemic of Diagnoses - New York Times

What’s Making Us Sick Is an Epidemic of Diagnoses - New York Times: "For most Americans, the biggest health threat is not avian flu, West Nile or mad cow disease. It’s our health-care system.

You might think this is because doctors make mistakes (we do make mistakes). But you can’t be a victim of medical error if you are not in the system. The larger threat posed by American medicine is that more and more of us are being drawn into the system not because of an epidemic of disease, but because of an epidemic of diagnoses."

Doctors are happy to over-diagnose - the more the patients they have, the higher their incomes ! We have ended up medicalising everything - just as Illich predicted in his classic, Medical
Nemesis !

Health Care Problem? Check the American Psyche - New York Times

Health Care Problem? Check the American Psyche - New York Times: "What may be less well known is the level of administrative waste in the United States health care system, versus that of well-designed systems elsewhere. Although Americans tend to equate efficiency with private enterprise, that’s not the case with the current system.

The American system, based on multiple insurers, builds in more unnecessary costs. Duplicate processing of claims, large numbers of insurance products, complicated bill-paying systems and high marketing costs add up to huge administrative expenses.

Then there’s an enormous amount of paperwork required of American doctors and hospitals that simply doesn’t exist in countries like Canada or Britain."

In health IT, consumer's role on the rise

In health IT, consumer's role on the rise: "If there is a next big thing in healthcare information technology in 2007, it will be the role of consumers in this sector of the industry, according to a consensus of experts. "

Cancer's unrecognized toll: Time lost - Yahoo! News

Cancer's unrecognized toll: Time lost - Yahoo! News: "The hours spent sitting in doctors' waiting rooms, in line for the CT scan, watching chemotherapy drip into veins: Battling cancer steals a lot of time — at least $2.3 billion worth for patients in the first year of treatment alone.

So says the first study to try to put a price tag to the time that people spend being treated for 11 of the most common cancers."

Once patients stop being patient, doctors will have to shape up !

Hospital CIOs across USA tackle demanding projects in 2007

Hospital CIOs across USA tackle demanding projects in 2007: "As 2007 dawns, CIOs at healthcare organizations across the country are gearing up for major IT revamps. They run the gamut from rolling out new clinical systems, installing new servers, and boosting wireless capacity."

What amazes me is how backward Indian hospitals have been. They have failed to grasp this opportunity to catapult themselves into the world-class league , even though India is supposed to be an IT powerhouse ! Most don't even have a CIO ( Chief Information Officer) and are still stuck using computers only for billing !

Wednesday, January 03, 2007

Regina Herzlinger: The Next Generation of Consumer Health Care

Regina Herzlinger: The Next Generation of Consumer Health Care: "
The largest service industry in the United States is undergoing a massive transformation that will release both providers and consumers from the strictures of managed care. How will this transformation affect you as a user, payer, or provider of health care? What can you do to help it along? Professor Herzlinger will answer these questions in her presentation."

Esther Dyson on Healthcare Venture Capital

Esther Dyson on Healthcare Venture Capital: "In this video, Esther Dyson addresses health care start-ups on the topic of raising money. Esther talks from the venture capitalist’s perspective on what the money people are looking for.

Investors are looking for something clear and focused. There is way too much opportunity in the health care space, so it is important for start-ups to stay focused on a small problem and do it extremely well, instead of being tempted to do everything. Otherwise, you will diminish your ability to do any one thing well.

Follow the demographics. Most of money spent on health care comes from people who are either very sick or very old. Go after specific conditions, specific populations, or specific times of life. You are selling to consumers. It is importantto understand how to market to people and excite them. Consumers have other things in their lives besides health care."

Risk Management - Saving Lives, Reducing Risk.

Risk Management - Saving Lives, Reducing Risk.: "The Sullivan Group has created a proven system to reduce medical risk and promote safety: web-based standardised risk and safety education, intelligent medical record tools for doctors and nurses, and a web-based clinical & system performance audit. The airline industry utilises this approach to create safe air travel. The Sullivan Group utilises this approach to change clinical behaviour, reduce errors, and save lives. The system is built on evidence-based medicine, recognised best practices, and our proprietary medical error and adverse outcome database."

Guest entry from Revolution Health

I am pleased to feature this guest entry by Brett Hodges , who has been doing pioneering work in empowering patients.

As you may have heard, my website RemedyFind has been purchased by a start-up company called Revolution Health. Revolution Health was created by Steve Case (AOL founder) and others, with the goal of bringing constructive change to health care. The aim is to give people the tools, information and support to actively manage their health and wellness. I’m now a Revolution Health employee and think the new company has the ideals, and resources, to really achieve some amazing things.

We will do this by attempting to answer (and solve) seemingly simple questions – Why do I have to fill out the same forms every time I go to a new doctor? Why are my medical records impossible to get a hold of? Why is it easier to find a restaurant than a doctor?

Our first step in trying to meet this lofty goal is to launch our web site. Over time, it will have some of the best technologies, communities and Internet resources assembled in one place. We’re in the testing phase right now and I’m inviting friends and colleagues to preview the site before it’s made available to the general public. We need your contributions to make this site truly great!

Please go to and register now (it’s free).

You’ll have immediate access to everything Revolution Health has to offer on our first day. Once you register, I hope you’ll visit us often at <> . You can also invite others to this exclusive preview, and I hope you do. They can access the site through the same address -

Here are a few things you can do on the site:

  • Rate your doctor and see what others say
  • Try a cool tool – understand your risks – learn what to do about them
  • Ask health questions and get answers from people like you
  • Fill out a profile and invite others into your circle
  • Learn about our upcoming health membership program

Note: By the way, if you have a Mac, you should use a Firefox browser instead of Safari (we are working on accommodating Safari for our public debut).

Thanks again for participating in our preview and for being an important part of the launch and building of Revolution Health.

All the best, Brett Hodges

Check out his website - this is the trend of the future ! Thanks to the internet, patients are going to have lots of options in the future - and hopefully as this becomes a buyer's market, the sellers ( doctors and hospitals) will offer patients much more choice !

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