Resolutions for 2012 on Health Train

 

New Year's Resolution(s)

The words I will try to never use in 2012.

Transparent,Open Source,Actionable,Ground breaking,Serial entrepreneur,Pioneer,Visionary, Futurist, Venture Capitalist, Killer-App, G4,LTE, Cloud, Outsourcing, iOS, WebOS, Apple, Microsoft, Windows 8, Virus, Trojan, Worm, Ver.n, Friend-unFriend, Timeline, Circle-Uncircle, Social Media, Klout Score, Mashable, Scobleizer, Timeline, Google, Facebook, Twitter, IPO, Start-up, Kindle, Kindle-fire, I (anything),Smartphone, QR codes, Work from Home, Tablet PC, Groupon, Virtual Machine, Wireless, Youtube, Online/Offline, Chrome, Extensions, Add-ons, Hot Tech Trends,

Outcomes, Meaningful Use, Incentives, ICD-10, SGR, Disruptive innovation, Physician pioneer, :Physician champion, ONCHIT, HIE, RHIO,

Things I will try to do:

No more than 6 #tags, No more than 5 @s, No more than 3 hyperlinks/blog post, Clean my gmail archives, review my Facebook app authorizations, Defragment my hard drives, Not update Windows 7 to Windows 8 for at least one year after it is released. Replace my aging router. Replace my aging laptop. And add an iSomething or other.

Spread cheer, humor, understanding and humility to all friends, love my enemies, obey my spouse, try to understand my children (now young adults) and remember that was me 40 years ago.

There are many more do not does and does, but I have a hand cramp.

I declare tomorrow December 31, 2011 as the last day of 2011 (by the powers vested in me?)

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Study Predicts Growing Use Of Social Media In Healthcare

 

Facebook study reveals deeper penetration of social media into healthcare than most would have predicted.

Patients seem more willing to adopt social media platforms that healthcare professionals.

It seems that patients will classify certain health related problems according to social acceptability, fears of retribution by friends, or employers or merely embarrassment. 

STDs appear to be highest on the list followed by cancer, neurologic problems such as aging, dementia, or mild strokes and/or memory loss.  Some parents do not want their children to know about serious or potentially fatal illnesses..

During my own social media contact with people (not my own patients) they will often inquire about their illnesses and express a desire to contact their physicians office for an initial encounter, even before a telephone contact.

Their may be several factors operating.

1. It offers bypassing clerical personnel, either by shortcutting a wait on the telephone, via telephone triage. It also offers after hours communications.

2. It depersonalizes the initial contact with a non-medical person, who they do not want to know about a personal problem.

3. Some have expressed a brief social media contact with the doctor would alleviate anxiety while waiting for an appointment.

4. Some perceive a professional social media contact as an act of caring and would offer a means of expressing anxiety, which might facilitate an earlier office visit.

5. The acceptance of these forms of communication have been limited by the feds. Ethics have been replaced with law.

6..Google + hangouts it turns out is not a secure platform, nor would an application on top of it be secure.

7.others

del.icio.us Tags: Google plus,twitter,facebook,social media,#hcsm

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Going the Distance

It is more difficult to maintain your privacy if you use the internet, even for something seemingly as benign as email or Google.

Google is more ubiquitous than the  yellow pages and is far more accessible.There are many analytics engines sweeping Google, twitter, Facebook and other social media for statistics and trends in internet use ranging from your network size, who influences you,who you influence, your areas of expertise and other unmentionables.  Klout is one site that you can access to have some idea of what analytics is capable of assessing about your internet usage. Most of these programs are free with limited functionality but for a price a much more invasive biopsy of your presence is available.

Caseblogs, Medical and Dental Health Blog has a check list for you to accomplish at least three or four times a year.

Here is his recipe for minimizing damage to your online self

Connectivity

Real WIMAX, (not  4G that delivers speed but not distance) may deliver on broadband health IT in remote and rural areas of the United States.

The FCC (Federal Communications Commission) is in the process of releasing “white space”, the television analog frequencies abandoned by the fiat of the FCC several  years ago. The white space will be used for ‘Wi-Max”  a wide area VHF wireless technology that has the potential for a 60 mile radius with one or several broadcast points. While the power limitations are very low and the speeds are low, it will enable much better coverage in rural areas at much lower cost. The adapters are simple and quite inexpensive, the first rendition that has been approved is from Koo Technologies.(KTS)  I believe this will enable  rural providers and hospitals to tie into the NHIN easily. The first test markets are in Delaware and Washington, D.C., and rural Virginia. Spectrum Bridge is an early provider for the technology.The technology requires a database  search for unused spectrum so that it does not interfere with other users in that portion of the radio spectrum. More details here (download).

The innovation will have a great effect on healthcare, as much as scientific advances in medicine. Connectivity has been rated in the top 10 of the best advances in medicine by USA News.

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Health Train Express Ends 2011

 

No, Health Train Express is not ending in 2011, rather is signals the time for the annual wrap up on 2011’s big news, small news, and no news.

All of this information need not be regurgitated here, but for those of you who automatically check here daily, I than you.

I have posted a number of links that will feed your never ending quest for information:

General News from the U.K.

Social Media in Medicine: The Answer to the Doctor’s Lounge

Best Hospitals 2011-2012 The Methodology

Best Hospitals 2011-2012

Top 10 Medical Breakthroughs: This one is a little more difficult to list. There are a number of determinants, such as basic science, specialization, public health and others which will effect efficiency and cost savings.

Listed in reverse order starting with:

10. Genetically Modified Mosquitoes to Reduce Disease Threat
9. Novel Diabetes Therapy: SGLT2 Inhibitors
8. Harnessing Big Data to Improve Heath Care
7. Active Bionic Prosthesis: Wearable Robotic Devices
6. Implantable Device to Treat Complex Brain Aneurysms
5. Increasing Discovery with Next-Generation Gene Sequencing
4. Medical Apps for Mobile Devices
3. Concussion Management System for Athletes
2. CT Scans for Early Detection of Lung Cancer
1. Catheter-Based Renal Denervation to Control Resistant Hypertension

You are free to chose a list from:

The Top List of Everything from Times Magazine

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Social Media in the Health Train

 

It seems no matter where you look on the internet the buzz this year has been about social media. Health care is no exception and there are many beating the band how valuable and perhaps essential it will become in the future.

Much of it will be dependent upon users preferences for efficiently using limited resources, the most important of which is time.

For physicians personally time is the most critical limiting factor. The use of social media is financially negligible unless  one chooses a social media manager to direct it’s operations. The necessity for this is dependent upon how much resource your organization has to handle this task.

The capital investment is close to zero.

Physicians can easily acquire the knowledge on how to limit breaches in privacy and confidentiality, and that can be passed on to workers in training.

There is some reason to believe that social media adoption may be approaching it’s limits due to time constrictions for employed people. And  doctor you fit in to that equation.  Your best income producing time is in the clinic seeing patients, or in the surgery doing procedures.

Hands on marketing for professionals between professionals is best done hands on face-face, in meetings, making rounds, lecturing for CME, taking an ER patient that is difficult or challenging due to insurance issues. The referring physician will forever be grateful, you will help a patient (even if you have to later refer him to a public facility later) and you may get some patients from the source that is insured or will pay a reduced fee.

So in reality you are already in social media….the difference is social media is also on the internet..digital social media.

Most users already are aware of many forms of social media, the most common ones being twitter, and Facebook. These two are unique and function differently although the same information can be exchanged in different ways.

Twitter has become a means of announcing and reporting medical meetings broadcasting tweets using a hashtag assigned for that particular meeting, as I have previously reported in a previous blog. It may be advisable for those developing annual meetings to assign a # such as AMA11 to designate a 2011 American Medical Association meeting, then changing it to AMA12 for next years meeting. Different Academies may also use their abbreviations as such but should take care to be certain it has not already  been pre-empted or users will receive some unwanted tweets.

So who owns your twitter account? That depends, as revealed in recent case law that is pending

Case in  point. Your employee who has been handling your social media leaves and takes with her social media information which may be proprietary in nature or take with him (her) the following they have developed in your social media stream. Who owns the content? That may depend on the nature of the conversation? Was it friend to friend or was it medical, marketing or financial information belonging to the medical practice.

 

Legal counsel may be advisable and also a clear guideline in your employee manual in regard to content using  your identification on Twitter, Facebook, Google + or any of the social media platforms

Courts Says Employer's Lawsuit Against Ex-Employee Over Retention and Use of Twitter Account can Proceed--PhoneDog v. Kravitz

Jeremiah Owyang ( A Web Strategist) of The Altimeter Group states the golden age of tech blogging may be over.

New models to emerge, long form content not the only way

Bloggers themselves know that relying on a single tool isn’t effective, they need a series of tools to use; “blogging isn’t dead. it may have gotten a LOT more social, and it may be less frequent now for those of us who also use Twitter / Facebook / Tumbler / YouTube for other distribution efforts, but the overall impact from these platforms together is BIGGER than ever before (and i maintain, also EASIER than ever before if you build it right).”

del.icio.us Tags: social media,blogging,twitter,facebook,google plus,social media liability

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Health Train Express Enters The Village with Sexuality Discussion and Google Plus Hangout

“It takes a ‘village” to raise a child” according to Hillary Clinton.

Amazing as it seems the latest survey reveals that up to 80% of physicians use one form or another of social media to interact with patients. This despite precautionary warnings about patient privacy and confidentiality.

The study did not reveal what form of social media they use; email, instant messaging, twitter, Skype or secured Google cloud documents. Google Cloud documents can be locked except for the intended readers.

   

 

Business uses the cloud for secure transactions and sensitive data, and there will be no shortage of offerings for medical applications. In fact, the cloud may offer a more cost effective and usable platform for a national health information exchange rather than re-inventing the wheel.

Now there is a new fast growing platform, Google + and even more revolutionary is Google + Hangouts.

Google plus Hangout and Sexual Ambiguity

The following topic was discussed on a public hangout broadcast by a public television station, KOMU TV in Colombia, Mo. Anchorwoman Sarah Hill is a pioneer in the convergent media space. She discusses a personal sensitive issue with Maya Posch born as a hermaphrodite. You will notice the film strip below the large screen of the Hangout participants. The ability to express herself with support from a public audience obviously gives this person hope.

Part I Interview with Maya Posch

Part II Interview with Maya Posch

The scope and power of social media cannot be underestimated among patients who share serious medical issues with like individuals. Caution, the content may be offensive to non-medical viewers. As mentioned in a portion of the video civil rights are part of the challenge in sexual ambiguity.

Please pardon the commercial message at the start of the video.

KOMU Live Stream Hangout Video

The New Google Health Village

Health care is now much like a village, or perhaps a group of villages which need to communicate. The convergence of the internet and  television, have created a new milieu. Internet or streaming video may replace classical Television much like over the air TV was replaced by satellite or cable.80% of cable television  users also hold a hand held device in their hands while viewing news or entertainment programs. They are frequently polled while watching, straw votes are taken during election campaigns.

The potential is great for social media for two way interaction with doctor and patient  using interactive teaching sessions for patients from your office, or clinic regarding diagnoses, treatment course and for  monitoring patient compliance.

With the support of Health Train Express Google product developers will develop a new platform, an API dedicated to a Google Medical Application, yet to be named.

Google, in it’s infinite wisdom designed the Google+ platform to be secure on a one to one circle share. It is possible to telehealth one to one. Images are of high quality. The medium is extremely cost effective, free for the moment.

The project will take several months to complete, and you may read about  it here when it is ready for a beta release.  Please subscribe to Health Train Express or use an RSS feed to see the announcement.

We are looking for suggestions and contributions about what functionality you would like to see in the new Google Medical API. Please tweet me @glevin1 or email me at riversideeyemd@gmail.com

del.icio.us Tags: social media,#hcsm,#healthit,#healthreform,hangouts,sexuality

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Window’s Notification Alert !! bong!

 

Today’s wake-up alert from The Washington Post

“The Obama administration Monday named 32 health care systems across the country as “Pioneer” ACOs. These will be the first places to test out the new payment model; they’ll provide a bit of a sneak peak at what it could mean for the rest of the country. In other words, we may soon see our first unicorns.

Unicorn, or not it is interesting that they chose 30 health systems which are already business entities and well integrated health systems. They are also located in unique health care markets.

Jim Hinton, President and CEO of Presbyterian Health System (one of the lucky 30 chosen makes these remarks in the Washington Post article authored by Sarah Klif.

“Jim Hinton: Health care has grown up in a fee-for-service system, and it’s also grown up with a system where the primary unit is an individual doctor taking care of an individual patient. At Presbyterian, we’ve been working on making care more integrated for 20 or so years now and have been able to do a lot by operating our own health plan..

A lot of what [the Accountable Care Organization model] does is build a system of care where there’s a safety net and we can help advocate for the patient. We’re looking at how can we do more with nurses and other advance practice professionals. How can we use technology? How can we change the visit model so its not one patient with one doctor every 15 minutes?

He offers some creative solutions for extending benefits such as home health care by up regulating it to a ‘home hospital’, reducing the cost of in patient hospitalization, but increasing the amount of home health care. To me this just seems to be cost shifting and would require major re-designs of accounting for the ACO.

All of these proposals are well hidden in the PPACA and the net effect is going to take a decade or more to be studied.

We’re experimenting with some group visits with doctors, and also another program where we hospitalize people in their homes. One good metaphor is thinking about it as if you were going to remodel your house. If you had a plumber, carpet-layer and someone putting down tiles not talking to each other, the house might not turn out very well. The idea is to anchor all the care in one place, where there’s a lot of coordination.

Mr Hinton summarizes it well for the rest of medicine.

““SK: As you mentioned earlier, your health system has been working on moving toward more integrated care for over 25 years now. What about the health care providers that haven’t been working on this stuff? How well do you think they’ll be able to use these new incentives?

JH: My colleagues who come from systems that have not owned managed care organizations are trying to assess how they can accelerate into this mindset. Most hospital systems today have some experience employing physicians but I think there are still two big barriers in going towards more integrated care. One is bringing an insurance perspective to populations, where you’re managing care and managing risk. The second is a cultural one. Many health care providers have fee-for-service as one of their core business models. It’s hard to get away from this notion that doing more health care means earning more money”

I do not see ACOs catching fire in much of medicine. In fact I predict that smaller towns will continue on their current merry way. Some ACOs may very well have to contract out some professional services depending on the willingness of the physician community to forfeit freedom and independence. This will invoked the laws of secondary consequences with it’s attendant unforeseen challenges.

Physicians resistant to ACOs may very well  boycott a local ACO if given that alternative.

Nothing for sure is certain.

del.icio.us Tags: aco,accountable care organization,incentives,outcomes,hhs,medicare reform,ppaca,integrated health systems

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