The potential benefits of mobile health care in treating patients with chronic diseases include improved doctor-patient communication and higher rates of medication compliance. Additionally, the proposed Stage 2 meaningful use rules require physicians to make electronic copies of records available to their patients. Therefore, it's imperative that health care providers find ways to overcome the hurdles that could stand in the way of using mobile technology, the experts said.
Dr. David Judge, medical director of the Ambulatory Practice of the Future primary care clinic at Partners Healthcare System Inc., listed a few of those obstacles. Integrating mobile device platforms into existing systems, engaging physicians in using the technology, and making sure doctors don't get inundated with information from remote monitoring devices are three of the main challenges that threaten to hold back the implementation mHealth practices.
With all the most advanced technology and equipment, spending far more on health care than any other nation — a whopping $2.6 trillion annually, or over 17 percent of our gross domestic product — the United States consistently underperforms on some of the most important health indicators. Our infant mortality rates, for example, are worse than those in countries like Hungary, Cuba and Slovenia. Our life expectancy rates are not much better; in global rankings, we sit within spitting distance of Cuba, Chile and Libya.
Rebecca D. Onie, a founder and the chief executive of Health Leads, a domestic health care organization; Dr. Paul Farmer, a founder of Partners in Health, a Boston-based medical nonprofit group; and Dr. Heidi Behforouz, medical and executive director of the Prevention and Access to Care and Treatment project, a community-based health care initiative in the United States that is part of Partners in Health, argue eloquently for “reverse innovation.” They contend that for decades, several nongovernmental and nonprofit medical organizations have delivered high-quality care in some of the most challenging circumstances possible. Applying the solutions these medical organizations have already discovered could allow us to bypass or at least foreshorten what has become an interminable trial-and-error search for the answers to our country’s health care woes.
Instead of providing antibiotics, CT scans and high-tech interventions, Partners in Health considers basic necessities like food and housing as critical components of the group’s medical work. Instead of asking patients to travel miles to the only clinic and see only the doctor or nurse, they train cadres of community health workers who can monitor, administer and advise in the heart of local villages and in people’s homes.
My Doc has been using an EHR system created by the company I work for. When they first rolled the system out, he spent a good bit of time behind the computer, but now he's really gotten the swing of things. He spent most of his time with me, referring once or twice to his computer screen. Apparently I have a pinched nerve, so he prescribed Prednisone and 8 weeks of PT. He confirmed with my who my pharmacy was, and in less that 10 seconds, the prescription was done.
In 2011, MINES had the great honor of presenting at the EAPA International Conference on Wellness Programs where we posited an alternative to traditional wellness programs that relied on the value of social media with employees as a means to increasing adoption, bolstering adherence through social relationships, and positioning health as a social venture where people are spending increasing amounts of their free (and yes, even work) time engaging in health. The core of most Wellness programs is similar to that of traditional EAP; a sort of ‘we’re there when you need us’ or ‘wait-and-see’ approach. Wellness programs, however, often incentivize participation through monetary carrots or sticks. This is a one-to-one approach to health. Those of you that get to play with relational databases, however, recognize that there are many ways to connect entities (data, people, sites, etc.).
The Mayo Clinic has begun conducting a series of tweet chats, which asks patients and healthcare providers alike to participate in idea generation (according to Healthcare Communication). The first topic was themed “The Patient of the Future.” In order to grow engagement with the chat, they utilized the hashtag #potf and encouraged interested parties to follow along and debate.
They asked three questions over the course of the tweet chat: 1) In the future, what will the #POTF expect from their provider? 2) In order to fit the needs of the #POTF, what changes in the health care system need to be made today? 3) What innovations in healthcare today will empower the #POTF and medical community, including physicians, medical students and patients?
According to CMS, through May of this year, 2,400 hospitals and 110,000 eligible professionals have received $5.7 billion in incentive payments for ensuring meaningful use of electronic health records, representing about half of all eligible hospitals and about 20% of all eligible providers.
Considering that one of the goals of the Meaningful Use incentive program has always been to improve interoperability in our healthcare industry, it’s hard to imagine that this market is best-served by having 600+ different vendors marketing thousands of different products. It certainly seems ripe for consolidation, particularly in the face of continued hospital-clinic alignment (and now payer-provider alignment as well), and the eventual drying up of Meaningful Use incentive payments.
The era of digital medicine just got one step closer to reality. The U.S. Food and Drug Administration (FDA) has for the first time approved a digestible device — a sand-particle sized microchip that can be embedded in drugs to monitor patients’ response to treatment, according to a new report in Nature
Radiation therapy is generally recommended for children with progressive LGA, or after failure of chemotherapy, accomplishing tumor control at 10 years in over 60% of patients. Cytotoxic chemotherapy is usually reserved for children who have had treatment failure with surgery and radiation therapy. It is also offered for children who are too young to be treated with radiation or to defer or avoid radiotherapy. Carboplatin and vincristine achieve 5% complete and 28% partial responses but the use of vincristine is criticized due to poor penetration of the CNS. A regimen of tioguanine, procarbazine, mitolactol, lomustine, and vincristine is frequently administered as an alternative to carboplatin and vincristine in LGA. The introduction of temozolomide has allowed better responses, including a 24% complete response rate compared with 0-5% complete response rates with the previous regimens. OPG are usually histologically LGA, and are treated with similar chemotherapy regimens. OPG is the most common type of brain tumor associated with NF