Wednesday, January 18, 2012

Mobile Technology Is Transforming The Health Industry


Mobile Technology Is Transforming The Health Industry, But To What Extent?


Dave Chase

Technology is in the process of bringing change to every piece of the health industry — wellness, fitness, healthcare, medicine — you name it. And as it always seems with introduction of new technologies, it’s awe-inspiring how quickly they can transform entire industries yet, at the same time, make us realize just how far we have to go (or how far behind we really are). The health industry has been touched (and defined) by cutting-edge technology for years, yet its relics, legacy infrastructure, paper-pushing, and archaic procedures are as obvious today as ever before.

Mobile Technology for health  can be classified in two categories:

Physician oriented: Apps designed to access reference materials, calculators, formularies, eRx, EMR remote access, Social Media, Calendaring, email, Video Conferencing, Algorithms

Patient oriented:Health Knowledge Base, Remote monitoring sensors, like Basis’ heart and health tracker,Lark, Fitbit, and Jawbone’s Up.

Some mobile apps interface patient and physician, Mobile devices will also change the way that we communicate with our doctors, as physicians may help describe possible treatments or procedures to patients on an iPad using multimedia, visual cues, genomic/anatomical maps, etc., prescribe post-treatment apps to our smartphones so that treatment doesn’t end once you walk out the door of the hospital, or become a conduit for modern communication platforms, a la Skype, that will facilitate remote checkups, treatments, diagnostics, through the phone, or over video. Got a strange looking rash? Take a picture, or scan it on this app. Telemedicine is there in a pinch!

All this has developed almost spontaneously with the development of competing hardware devices and software which is open source. and at affordable prices given the size of the patient market. The primary ingredient is innovation, entrepreneurial spirit, and with little governmental funding and/or intrusion.

Contrast this with the stuttering acceptance of EMRs and HIEs with government mandates, artificial support with incentive subsidies to support the HIT vendor market. The real beneficiary for CMS’ incentive program are the HIT vendors, not patients, not doctors nor insurers. The data collectors will benefit from the system which will be mined for the benefit of cost containment and perhaps better outcomes.

Tuesday, January 17, 2012

Social Media in a Hospital Bed


No this post is not about pubescent hormonal hyper sexuality nor the story about the sex life of fan boys or fan girls,  G+strings,, or tantalizing twitter tweepes. It is a story about Fred and Regina Holladay and their experience (bad) when Fred was diagnosed with advanced Renal Cancer.

Dr. to Dr.
View more presentations from Regina Holliday

The program is self-explanatory and does not require expansion here.

Bold New Approach to Funding Medical School Tuition



Over the past ten years both college and medical school tuitions have increased in some cases four times. This has effected college graduates and physicians. Tuition at the state run UC system in 2001-2002 was $ 3429 and has risen to  $13,200 per year. This places an extraordinary debt burden on students at a time when they have little income.


In California which has faced the perfect storm of decreasing revenues in the face of economic distress Chris Occasion, President of the FixUCR movement at the University of California presented a manifesto

Their manifesto is the UC Student Investment Proposal, which calls for eliminating the upfront costs of college and having working graduates pay 5 percent of their salary back to the system for 20 years.

The idea was conceived by students, and although designed for the UC system could very well be adapted to  other states and private universities.

The investment proposal concept has captured the attention of the Board of Regents of the UC system and was a concept previously studied and discussed by Robert Reich former Secretary of Labor under the Clinton Administration. He presented a similar idea in 2008 for California’s  mounting fiscal stresses. Economists at the time termed the financial plan feasible however it was deemed politically undoable. This would not be the same for privately funded schools of higher education.


A similar perfect storm has developed in health care and medical education which is even more expensive and extended eight years up to twelve years. And while college graduates may complete undergraduate education with a $100,000 debt load, some physicians will  exit from medical student and

training with up to $ 250,000 debt. image

Health reform promises two events, more insured patients, decreased reimbursements and a shortage of primary care physicians (family physicians).This will decrease ability for  physician graduates to repay  education loans. Adjusting payment rates as a percentage of income adjusts for future changes in income.

Many well qualified students rule out medicine as a career because of it’ prospect of prolonged poverty and what often appears to be insurmountable debt. Some highly qualified  students will change career goals

ref: Zimmerman, Riverside Press

Friday, January 13, 2012

5% of patients account for half of health care spending


USA TODAY reports that 22 % of healthcare spending is from less than 1% of patients.(2009).

That's about $90,000 per person, according to the Agency for Healthcare Research and Quality. U.S. residents spent $1.26 trillion that year on health care.

Five percent accounted for 50% of health care costs, about $36,000 each, the report said.

Why is this number so important? According to AHRQ the report showed how a tiny segment of the population can drive health care spending and that efforts to control cost should focus on this segment to improve efficiency using new technology, outcome studies,

About one in five health care consumers remained in the top 1% of spenders for at least two consecutive years, the report showed. They tended to be white, non-Hispanic women in poor health; the elderly; and users of publicly funded health care.

•Sixty percent were women

•Forty percent were 65 or older.

•Only 3% were ages 18 to 29.

•Eighty percent were white.

•Only 2% were Asian.

The  found that Hispanics, 16% of the population in 2009, spent less on health care. Twenty-five percent of Hispanics were in the bottom half of health care spenders, the report showed, while only 7% of Hispanics were in the top 10% of spenders.

Next, Cohen plans to look at whether cost-cutting measures make a difference. Beginning in October 2012, the government has told hospitals with Medicare patients that it will no longer pay for patients who are readmitted to hospitals for the same condition soon after being released. Cohen said he'll look at whether that will change the spending averages for people in the top health care cost brackets.

Another way of stating this is, “unmarried women” (uninsured) (or Medicaid)  and  old people on Medicare

Tuesday, January 10, 2012

C.E.S. & Health Train Express in Vegas



Monday January 9 2012 marked the opening of the Consumer Entertainment Show in Las Vegas.

Among the carnival-like presentations both on the exhibit floor and in conference were many medical applications in hardware and software.  After all,, medical practices and physicians are consumers.

Connectivity is high on the list of presentations.. Physical security of the mobile hand held devices was important, however the real value is the software and data in the device.

Consumer oriented health monitors were also on the list:

This one is from Zensorium. and intended for iOS. (iPhone)

RFID for security is available with small tags on laptop cases, smartphones, iPads and the like “Tags” are available for pets and even children to keep them from wandering off. It could even be used for ‘colleagues’ and peers to keep from losing each other even significant others or spouses.  (in an extreme case).The potential for use in hospitals is great to locate patients who may be roaming to special testing. Physicians hate going to an empty room when they expect to see the patient.

Digital healthcare was no stranger at the CES. From Panasonic to Allscripts medical applications are being mainstreamed even in the consumer retail market place.  COSTCO offers the  Allscripts My Way EMR which can be purchased at any Costco warehouse.

In addition to mobile apps and advances in display technology the merger of automobile connectivity within the vehicle and also externally for safety features are being emphasized as selling points for vehicles

Ford, Microsoft, Healthrageous and BlueMetal Architects announced an alliance to research technology to help people monitor and maintain health and wellness while on the move during the “Doctor in Your Car” keynote address at the Digital Health Summit at the 2012 International Consumer Electronics Show (CES).

An interesting statistic (Pew)

More people now visit online health sites than go to the doctor’s office, making health and wellness the most popular activity on the Web after email and general searches.

Social media was also a large component of the CES. Reporters, presenters, and observers were all well connected via email, im, twitter, FB and Google +. Multi-tasking was a necessity on the floor and in the booths. The infrastructure to support this seemed to be better than in most previous CES’ The learning curve from previous event was obvious and the ‘show’ ran smoothly There appeared to be little difficulty with broadband access nor bandwidth. Convention centers seem to have caught up with the never ending growth of demand for wider ‘pipes’.. I watched much of #CES from the comfort of my desk , at  C-net, and Techcrunch,and .

It eliminated the challenges of air travel, TSA and DHS.


Senior Citizens on the Health Train

  1. GeriPal (blog)
  2. POGOe – Portal of Geriatric Online Education (clinical resource)
  3. Geriatric Nursing (podcast)
  4. CareGiving (community site)
  5. The American Geriatrics Society Like (Facebook group)
  6. Wen Dombrowski MD (Twitter)
  7. American Geriatrics (Twitter)
  8. GeriPsych Consult (mobile app)
  9. Health AGEnda (blog)
  10. John A. Hartford Foundation (Youtube)


Senior citizens are getting much attention from politicians and health care professionals. Deservedly so since they are the unfortunate who are involuntarily ‘consuming’ health care. It’s the nature of aging and human life.

No one wants to be ill or infirm. The term “consumers of health care’ implies that healthcare is produced, or that health itself is produced. Perhaps that is what preventive medicine, healthy diets, exercise, stressful living and a good quality of lifestyle is all about.

The list of links at the start of the article is for mature adults and their caregivers. (credits to Bertalan Mesko MD and Webcina.  I recommend giving it to  you patients.

Saturday, January 7, 2012

Is 2012 The New Era for Health Train Express?

Better Health (TM): smart health commentary

Val Jones MD, perhaps the empress of health social media, and Better Health has announced her discontinuation of posting blogs on Better Health LLC. She however indicated the continuation of the brand as a platform for Grand Rounds and for her use of it as her personal consulting platform.

Dr Jones, along with others, has been a visionary and developed considerable credibility with early backing from Revolution Health and Steve Case’s interest in health reform.  Her success required considerable investment of time, resources and the generous support of many silent investors, physicians, nurses and medical journalists.   She innovated aggregation of gifted medical writers into a visible public platform for medical news.

There were and are a central core of respected experts contributing to Better Health and these contributors will continue to create content in their own spaces.

Thank you to Val Jones M.D. for her effort and success in opening a new vista in communication for patients and providers. I will miss her cartoons.

The range of contributors to Better Health include:

David Harlow, Dr Wes, Dr. Mike Sevilla, Kevin Pho MD,Lucy Hornstein M.D.,Nicholas Genes M.D.,Steve Novella M.D.,, Tony Brayer M.D., Jeffrey Benabio M..D.,

Better Health was and is more than a blog. It matured into a digital form of a medical journal, branding itself as an online media company. It has served it’s purpose and will continue in the digital health space, not to be left behind.

Many new entities are evolving, such as Social Media Today, Health Works Collective, and many others as the niche matures.these follow the early leadership of iHealthBeat, and California Healthline.

Social media in medicine is evolving quickly and in order to continue our success we must all evolve as it morphs into new delivery methods.

I am sure we will hear much more from Val Jones MD

Thanks Val.

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