The GV Hot 7, especially the finally-acknowledged physician burnout. Google Ventures’ (GV) Dr. Krishna Yeshwant, a GV general partner leading the Life Sciences team, is interested in seven areas, according to his interview in Business Insider (UK):
- Physician burnout, which has become epidemic as doctors (and nurses) spend more and more time with their EHRs versus patients. This is Job #1 in this Editor’s opinion.
Dr. Yeshwant’s run-on question to be solved is: “Where are the places where we can intervene to continue getting the advantages of the electronic medical record while respecting the fact that there’s a human relationship that most people have gotten into this for that’s been eroded by the fact that there’s now a computer that’s a core part of the conversation.” (Your job–parse this sentence!–Ed.)
Let’s turn to Dr. Robert Wachter for a better statement of the problem. This Editor was present for his talk at the NYeC Digital Health Conference [TTA 19 Jan] and these are quoted from his slides: “Burnout is associated with computerized order entry use and perceived ‘clerical burden’ [of EHRs and other systems]”. He also cites the digital squeeze on physicians and the Productivity Paradox, noted by economist Robert Solow as “You can see the computer age everywhere except in the productivity statistics.” In other words, EHRs are a major thief of time. What needs to happen? “Improvements in the technology and reimagining the work itself.” Citing Mr. Solow again, the Productivity Paradox in healthcare will take 15-20 years to resolve. Dr. Wachter’s talk is here. (more…)
Back in June at CEWeek
this Editor viewed the newly redesigned, retro-looking AdhereTech
medication bottle [TTA 10 July
] and thought it a substantial step in appearance and feel in the hand above 1.0. It dispenses normally, lights are brighter, sounds are louder, it communicates wirelessly to track consumption and reminders, works internationally and has a three-time greater battery life.
Compliance is a huge US business with pharma companies baying at the moon for it as a raison D’être of digital health. AdhereTech is working with Cincinnati Children’s Hospital, Weill Cornell Medical Center, and Walter Reed Army Medical Center on clinical trials. AdhereTech’s studies now indicate that users get about a 20 percent lift in adherence versus a standard bottle, and 80 percent of patients given the option of using AdhereTech or a normal bottle opted into the smart bottle. Like Medisafe [TTA 30 Oct], their market is millions who have one or more chronic diseases, but they sub-target those who take more and more expensive medications which can justify this pill dispenser’s cost. Mobihealthnews, FT interview with team early last month
Medisafe, a medication reminder app from Haifa, Israel with offices in Boston, partnered with IMS Health for a study of their app with a test group of 700 patients total with diabetes, hypertension and hyperlipidemia (high cholesterol). Over the study period–six months for hyperlipidemia and hypertension, three months for diabetes–adherence improved 10.7, 5.4 and 7.7 percent respectively versus a control group. The app was rated by IMS’ AppScript app curation team in a recent report as the highest-rated medication management app in terms of AppScript score. Medisafe also enables care collaboration among physicians, patients and families, and also provides personalized content. PR Newswire release. MedCityNews.
The Commonwealth Fund‘s just-published study on mHealth usage in a national sample of urban and rural community health centers and clinics (in US termed ‘safety net providers’ for low-income and uninsured) indicates the potential of mobile health for patient engagement in care, but yet to be achieved. Their patient population has high levels of mobile phone adoption, including text and internet. About 27 percent of the 181 providers who participated currently use mHealth in care delivery, but in basic applications such as appointment reminders. The potential observed is in chronic disease management support, health education and specific programs such as smoking cessation, weight management and medication adherence. Mobile Health and Patient Engagement in the Safety Net: A Survey of Community Health Centers and Clinics Also FierceMobileHealthcare.
This editor was involved in the development of two events at the Academy of Medical Sciences that took place at the end of 2014, the reports of which have just been publicised.
The first, on medical apps, brought together a wide range of stakeholders to:
- Explore the current and proposed regulatory frameworks for health apps;
- Hear case studies of the development of health apps and of the regulation and oversight of software development in other medical, nuclear and automotive sectors;
- Discuss the current and future challenges faced in the oversight of health apps and devise solutions to these issues.
Particular issues raised during the day included: (more…)
As intimated in our review of last year’s predictions, we feel little need to change course significantly, however some are now done & dusted, whereas others have a way to go. The latter include a concern about doctors, especially those in hospitals, continuing to use high-risk uncertified apps where the chance of injury or death of a patient is high if there is an error in them. Uncertified dosage calculators are considered particularly concerning.
Of necessity this is an area where clinicians are unwilling to be quoted, and meetings impose Chatham House rules. Suffice to say therefore that the point has now been well taken, and the MHRA are well aware of general concerns. Our first prediction therefore is that:
One or more Royal College/College will advise or instruct its members only to use CE-certified or otherwise risk-assessed medical apps.
The challenge here of course is that a restriction to CE-certified apps-only would be a disaster as many, if not most, apps used by clinicians do not meet the definition of a Medical Device and so could not justifiably be CE-certified. And apps are now a major source of efficiencies in hospitals – (more…)
As we in the US get our first, much too early blast of Polar Vortex this season with New York area temperatures dipping into the 30s F with a snow alert tonight, we should reminisce about what seems only a few weeks ago when the keyword was ‘short’….
Coming up short in the data breach this past Monday was Anthem Blue Cross of California with their TMI emailer–containing in the subject line specific targeting/sorting patient information that direct marketers love, but don’t want you to know they see, such as “Don’t miss out — call your doctor today; PlanState: CA; Segment: Individual; Age: Female Older; Language: EN; CervCancer3yr: N; CervCancer5yr: Y; Mammogram: N; Colonoscopy: N”. Ooops!…Another day, not quite another breakthrough for Mount Sinai Hospital here in NY, which had your typical laptop theft compromising over 10,000 records but fortunately not SSI or insurance information….More alarming were the malware/hacker attacks. In North Carolina, Central Dermatology of Chapel Hill was compromised by malware in a key server. And further south, Jessie Trice Community Health Center of Miami, Florida was hacked by a criminal identity theft operation accessing personal data of almost 8,000 patients. iHealthBeat, also Privacy Rights Clearinghouse, NY Times (Anthem)
A short opinion piece in HealthWorks Collective promisingly leads with:
What if we paid for patient recovery rather than just patient services? What if we paid to treat patients rather than just conditions? What if we paid to personalize care rather just population health quality measures? (more…)
Telehealth & Telecare Aware has largely moved on from individual reporting of incidents. However once in a while it is perhaps worth sitting back to review the recent past, and look to the future. In telecare, the world of environmental sensing has developed so fast recently that it takes an incident like that reported in Harlow last month where it appears as if (more…)
This Vitaphone item does a most creditable job of getting behind the common misperception, covered in previous posts, that people don’t take medicines because they forget.
For me it doesn’t however address the issue of beliefs quite strongly enough though. To give an extreme example, when I worked in Newham there were people who believed that illnesses were supernaturally visited on them because of things their forefathers had done. To expiate those things, they had to suffer stoically. The end result was that, even when diagnosed, medication prescribed and lifestyle advice given, some patients allowed eminently treatable conditions such as diabetes to deteriorate rapidly, unless those beliefs were addressed effectively.
In an interesting Viewpoint article in today’s GPonline entitled “Future proofing disease management”, Dr Raj Thakkar introduces the acronym CLOUD, which stands for Co-morbidity management, Lifestyle management, Outpatient monitoring (in primary care), Up-titration of drugs and Drug adherence.
Most readers will be very familiar with (more…)
In spite of gamification being at the peak of inflated expectations in the 2013 Gartner Hype Cycle, here’s a great example from the US journal Pediatrics of its use to encourage young people with cancer to improve their medication adherence. The subject was also covered in the BBC’s Click (starts 13.55 into the programme), and the Hope Labs website is here…
…which prompts the question as to where the best examples of gamification use to improve health & wellbeing are on this side of the Atlantic. (more…)
One of the greatest misconceptions I had when I first got involved in telecare was that the main reason that people don’t adhere to their medication regime is that they forget to take their medicine – therefore all they need is an automated pill dispenser or perhaps even an alerting system and all will be well. If only it was so simple!
In reality there are all sorts of reasons, such as (more…)