Nov 30, 2012

Social Media To Be The Commonest Source Of Continuing Medical Education

social-media-brings-changes-in-healthcareSocial Media is the commonest use of Internet. Everyone uses the internet to access their emails and Facebook accounts. A Google search engine is the gateway to all information for most of us. These platitudes of an everyday normal life also apply to physicians.
Communication technology has made things easy for doctors. Keeping up-to-date with medical advances has become an easy part of everyday life and not restricted to events like conferences or receiving prints of journal publications. Recent publications have highlighted the importance of social media in continuing medical education. In a recent large study, 70% of doctors were found to have accessed new medical content via social media every month.
Social media integrated medical content platforms like India Cardiology 2.0 and India Rheumatology 2.0 make it easier to read, share and discuss the latest studies and articles within the niche. Such platforms let readers (which in most cases are doctors) recommend and easily share the relevant study on their Facebook wall. Reader recommendations on the website are used to list the most visible studies. On such social media integrated medical content platforms, Readers can choose to stay updated via email (enewsletter) or via Facebook page or Twitter. So, for example, on liking India Cardiology 2.0 Facebook page the latest news and articles in Cardiology shall be visible to readers on their Facebook wall stream. Readers can also use common social media platforms including LinkedIn and Google plus to recommend the article to his/her own friend circle with pertinent comments.
FireShot Screen Capture #062 - 'Digoxin Increases Deaths In Patients With Atrial Fibrillation - India Cardiology 2_0' - cardiology_hcsm_in_2012_11_30_digoxin-increases-deaths-in-patients-with-atrial-fibrillation
Similarly, following @incardiology on Twitter will let a reader receive all new updates in his/her twitter stream/wall. Such platforms make finding and sharing relevant items so much simpler for medical professionals.
Social media and emails are well ingrained into our daily lives. Its time doctors make professional uses of such tools too.

Nov 29, 2012

Portable UV Disinfector To Control Hospital Acquired Infections

Technology provides hospitals with tools which can greatly improve their quality of care. This small portable disinfector is one such tool.

Hospital acquired infection is an age old problem which refuses to go away. Infections acquired during hospital stay still constitute one of the top 5 causes of mortality in patients. Antimicrobial solutions and fogging help in reducing the microbial burden but they have their limitations. Enter Xenex.

Xenex

The futuristic looking Xenex room disinfection system uses pulses of high-intensity ultraviolet light to kill bacteria without contact or chemicals. The device can be moved from room to room, and can disinfect surfaces and the air in a matter of minutes. The system uses reflectors and movement to focus UV light toward “high-touch” surfaces. Motion detection system and door guard ensure the safety of patients, visitors, and staff. On-board database logs system activity for utilization tracking and analysis.

In hospital trials, Xenex was found to be 20 times more effective than standard cleaning methods, and a recent study proved it is more effective than bleach in reducing C-difficile.

Nov 17, 2012

What doctors don't know about the drugs they prescribe : Video

Medical Journalism and communication has become sensationalistic. Potentially beneficial results are overhyped and harmful possibilities simply brushed under the rug. Positive findings are around twice as likely to be published as negative findings.

When a new drug gets tested, the results of the trials should be published for the rest of the medical world -- except much of the time, negative or inconclusive findings go unreported, leaving doctors and researchers in the dark. In this impassioned talk, Ben Goldacre explains why these unreported instances of negative data are especially misleading and dangerous.

Freeing Medical Data: Video

Technology has enabled us to collect vast amounts of medical data from myriad sources. But most of this data is locked in silos and unavailable for use by researchers. Performing a medical or genomic experiment on a human requires informed consent and careful boundaries around privacy. But what if the data that results, once scrubbed of identifying marks, was released into the wild?

At WeConsent.us, John Wilbanks thinks through the ethical and procedural steps to create an open, massive, mine-able database of data about health and genomics from many sources.

Nov 9, 2012

Benefits and Risks of Healthcare Social Media

healthcare-social-mediaSocial media includes all online tools and technologies which let people communicate and publish content easily. The most popular among them are Blogs, Facebook, Twitter and YouTube. Widely used for communications and marketing, these channels are considered as important (if not more important) as mainstream media channels like newspapers and television.

The use of social media in healthcare represents an increasingly effective tool in healthcare. It can be used to communicate with consumers, inform about new wellness schemes, market healthcare products, provide basic healthcare advice, inform about latest medical devices, get instant public feedback and much more. At the same time, Healthcare social media also presents challenges, including risks to information accuracy, organizational reputation, and individual privacy.

The primary focus for most organizations' social media programs is marketing and communications. Hospitals are using social media to target health consumers. As consumers are shifting to online searches before making important healthcare decisions, hospitals are looking at creating solid social media presence and fostering long term relationships with their consumers. Internationally, Mayo Clinic has taken the lead in healthcare social media. Mayo Clinic’s Center for Social Media has a stated mission to "lead the social media revolution in healthcare, contributing to health and well being for people everywhere." Indian hospitals are not far behind. The Apollo Hospitals twitter account has more than 2000 followers. Their Facebook page makes wonderful use of the timeline feature, has 91,000 likes and is fast growing. Their YouTube channel has been active for the past 4 years.

Many organizations have also formed online support groups for patients. Patients are encouraged to share their personal experiences and this consumer generated content is an invaluable source of information for other patients. Many doctors, too, have joined such support forums and provide information on various disorders. In a country like India where 70% of healthcare services are paid for ‘out-of-pocket’, Social Media becomes all the more important for healthcare marketing. Companies selling healthcare devices have found social media influences purchasing decisions. Internationally, many pharma companies too have realized the enormous potential of social media. Almost all major drug companies now have social media presence. Companies like Pfizer, Novartis, J & J and Sanofi-Aventis have launched many innovative social media campaigns. The HR departments in many healthcare organizations are using social media sites to spot and recruit talent.

These new tools of communications come with their own risks and dangers. Like a double edged sword, all points in favor of social media usage also contribute to the dangers associated with their use. The dangers social media exposes healthcare to are internal as well as external. Flippant remarks made by nurses or doctors online can be misconstrued by general public. Cases abound where protected health information was shared online inadvertently. The danger of violations of patient privacy cannot be overstated.

Conversations cannot be controlled and negative remarks made on social media by disgruntled employees or consumers cannot be erased. Such risks can be minimized by fostering positive comments by consumers and show casing achievements and consumer centeredness via these communication channels.

Organizations need to gear up to grab the opportunity and face the challenge that is social media. They need to monitor their ‘social presence’ and keep track of consumer sentiments. Use of social media for innovative marketing and communication campaigns should be encouraged. Organizations should educate both their employees and the public on their privacy practices to encourage responsible use of their social media sites. Guidelines and specific social media policies need to be in place to promote risk free use of social media by employees. Once policy is established, employees, volunteers, contracted employees, and medical staff members should receive training and education to ensure they are aware of the policies and procedures. With proper policy and training for employees, healthcare is slowly but surely taming the social media beast that technology has helped unleash on the markets.

Also See:

· Pharma and Healthcare Social Media Wiki: http://bit.ly/hcsmwiki

· Online Database of Healthcare Social Media Policies: http://bit.ly/hcsmpolicy

· Privacy Policies for Social Media: http://journal.ahima.org/2010/01/06/social-media-policies/

Nov 6, 2012

Top 10 Health Technology Hazards For 2013

The evolution of healthcare information technology systems such as electronic health records (EHRs) has definitely helped improve quality and efficiency in healthcare. At the same time, there’s a growing level of complexity and opportunity for error. With increasing use of technology in healthcare, healthcare providers need to be wary of the associated risks with its use.

Now in its sixth year, ECRI Institute publishes an annual list of top hazards of technology in healthcare. The Top 10 Health Technology Hazards list is updated each year based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis, and expertise of the organization’s multidisciplinary staff. Here are the group’s estimation of the most probable hazards which might crop up in 2013 because of use of technology in healthcare.

1.  Alarm hazards

2.  Medication administration errors using infusion pump

3.  Unnecessary radiation exposures and radiation burns during diagnostic radiology procedures

4.  Patient/data mismatches in EHRs and other health IT (HIT) systems

5.  Interoperability failures with medical devices and health IT systems

6. Air embolism hazards

7. Inattention to the needs of pediatric patients when using “adult” technologies

8. Inadequate reprocessing of endoscopic devices and surgical instruments

9. Caregiver distractions from smartphones and other mobile devices

10. Surgical fires

You can download the original report by registering here.

Here are the lists of Top hazards for 2010. for 2011 and for 2012

Photo credit: @Jacobsons on Flickr (CC BY-NC-SA 2.0)

Oct 14, 2012

Ten Most Innovative Companies In Healthcare 2012

Fast Company routinely publishes their list of 'Most Innovative Companies'. You can find their earlier list here. Here's  their list of most innovative companies in healthcare for 2012.

Their use of technology shortens the 'Bone marrow transplant' time by using an online hub that helps keep donors and recipients on track during the steps before transplantation. They have also added new matching algorithms to improve search accuracy. NMDP makes extensive use of social media to search for new donors.

India's pride, this is one institution which has beautifully married public and private healthcare enterprise, among it's many other innovations in healthcare services delivery.


They are a $70 billion company and the largest drug store chain in the U.S. They offer some amazing online deals in healthcare products.

Like a price compare in Healthcare services allowing you to bargain, Castlight Health provides transparency into cost and quality, so individuals can make informed decisions about health care.

5) Assistivewear
Found in 2000, they are a truly innovative firm working on assistive technology software for Mac OS X and iOS. Their inclusion is for developing a Virtual on-screen keyboard for users who cannot use a physical one.

6) IBM
They are a fixture in any such list of 'most innovative companies'. This time, they feature on the list for their hugely popular 'Watson supercomputer'. Watson is expected to soon bring its massive artificial intelligence algorithms to help improve healthcare and clinical medicine.

A niche player in orthopedic devices, they are in the list for building the "smart" knee, the first motorized, personalized prosthesis.


A preventive healthcare services company, they are in the list for funding a data-mining competition to reduce unnecessary hospital visits. 

 A mapping software (G.I.S) company, they have brought in the concept of commercial use of 'Geo-medicine', where they use mapping software to help in diagnosis, management and prevention of diseases (many of which have an environmental trigger).

10) 3M
A large product manufacturing company, they have about 55,000 products in the market, many of them in the healthcare and electronics. Their inclusion is because of their cardiology grade Littmann® Electronic Stethoscope.  



Sep 12, 2012

Doctors in Australia Will Please Maintain Silence on Social Media.

The Americans never got it right in healthcare anyways. The Canadians have a beautified version of the same. The Europeans have their hearts in the right place and are still working on theirs. Now its Australia's turn.

Healthcare social media is definitely the elephant in the room and the Australian Health Practitioner Regulation Agency (AHPRA) has geared up to fulfill its mandate of “maintaining public safety at its heart”. They recently released their preliminary consultation paper on social media policy for healthcare practitioners:
A draft of the social media policy has been released as a preliminary consultation paper to targeted stakeholders for initial feedback, ahead of a wider public release....The policy reflects the National Boards’ role as regulatory bodies with respect to social media and does not provide more general professional advice.
The preliminary consultation process aims to ‘road test’ the initial draft to weigh operational impact, issues or initial concerns. As expected, Australian doctors have been forced into fighting for their rights! True to its name ‘practitioner regulation agency’, AHPRA has come out with its set of recommended ‘must-nots’ and penalties. This particular draft  is so ‘advertising’ centric, AHPRA misses out on their wider role to “develop or approve standards, codes and guidelines for the health profession”. Advertising in Social Media is only the tip of the iceberg.

As @edwinkruys hints in the comments here, some of the policy statements are plain dumb. While questioning the very need for the document's existence in the present format, some very relevant positions have been outlined on this Crikey health blog. The scope and expectations of the community this document hopes to regulate will hopefully be taken into serious consideration, even it means reversing some old policies.

In its zeal to regulate what they call advertising, the current draft borders on violating right to speech and the freedom of expression. The wordpress blogger Carolyndv says it eloquently “What use are we as healthcare workers if we cannot engage with our community about their health and wellbeing?”. If "Disclosing personal information on social media to current or former patients may breach professional boundaries", they are effectively trying to silence doctors on social media. As a regulating body for developing/approving standards and guidelines, what APHRA also needs to do is define protected health information and state the patient parameters/details which should not be revealed in Social media. It is these sort of definitive guidelines the document lacks while gleefully throttling health information rights of the consumer.

The AHPRA is taking in suggestions till 14th September after which they will hopefully come out with a more rounded and practical draft of social media regulatory guidelines for physicians. Later, the National Boards in the National Registration and Accreditation Scheme (National Scheme) will release a consultation paper on social media policy in October/November 2012.

Aug 3, 2012

Indians Expect To Lead The mHealth Revolution : PwC Survey

 
With large penetration of mobile phones in the country (close to 1000 million cellphone users, teledensity >79%), India has realized that mHealth adoption will play a very important part in improving access and quality of healthcare in the country. Countries like China, Brazil and the US have all turned to mHealth in varying degrees. There are significant differences in mhealth adoption among emerging and developed nations. A recent survey from PricewaterhouseCoopers tries to assess the climate for utilization of mHealth in 10 developing and developed countries.

The extensive study included patient survey with over 1,000 respondents, physicians’ survey with 433 physicians and a payer survey with 345 respondents. The study shows that expectations are high for mHealth from patients, providers and payers. Consumers are ready to adopt mobile health faster than the health industry is ready to adapt. Here are a few key findings from the study relevant to India:
  •  India and China scored the highest in openness and awareness of mHealth. China shows higher use of mHealth at present compared to India, though the environment in India was felt to be most encouraging of all countries. From the ten countries in the study, Indians expect mHealth to have the largest impact on healthcare. 60% of Indians surveyed felt that widespread adoption of mHealth services is inevitable in the near future.
  • 92% of physicians in India expected a noticeable effect of mHealth in 3 years. Also, 52% of physicians in India believe the widespread adoption of mHealth is inevitable.
  • Patients in emerging markets like India and China are more willing to pay for mHealth than their counterparts in the developed countries.
  • Despite the optimism and the desire, India scored the lowest on the technology front. Technology was found to be most mature in Denmark and US.
  • Telephonic consultations, Administrative communication and Remote patient monitoring are the most popular uses of mHealth in India. Remote access to EMRs is fast gaining in importance.
The main drivers for patients using mHealth in India are
  1. To reduce own healthcare cost,
  2. Improve access to providers,
  3. Ability to obtain information.
The main barriers in patient adoption of mHealth in India are cost, lack of relevant applications and unwillingness of doctors.

The main drivers for physician use of mHealth in India were
  1. Lowered overall cost of care for patients,
  2. Ability to reach previously unreachable patients and
  3. Saving of time otherwise spent in administrative functions.
The main barriers in physician adoption of mHealth in India were lack of interest and unavailability of information about mHealth.

Of all stakeholders, Physicians are generally the most reluctant lot to adopt mHealth. In the whole study, 60% of active users of mHealth say that patients and technology companies are more interested in mHealth than physicians. Though Indian physicians seem more amenable to adoption of mHealth compared to physicians in most other countries, we still have a long way to go. Having doctors join the mHealth revolution will be the key to ensuring optimum benefits for the patients. And that, my friend, is going to be a tough task.


Jul 21, 2012

Doctors on Google: Manhattan Research Survey 2012

It is important for the healthcare industry stakeholders in India to keep a close watch on physician practices in the United States as the same behaviour is soon replicated in Indian metros because of a large proportion of US returned doctors. Google partnered with Manhattan Research to conduct a very revealing physician survey recently which also has implications for the Indian markets.

A total of 506 practicing US physicians were surveyed online between February and March 2012 to assess their use of digital tools and new media. Here are some of their key findings.
  • 87 per cent of physicians use mobile devices like smartphones or tablets.
  • Physicians perform an average of 6 professional searches a day
  • 68 per cent of physicians are prompted to use a search engine because a patient seeks more information during a consultation
  • When search is used, 77 per cent  of the physicians use it between patient consults while 41 per cent physicians agree to having used it during patient consults.
  • 84 per cent of physicians search on condition related keyword terms. Only 17 per cent search on pharmaceutical manufacturer terms
  • 93 per cent physicians have taken action after consulting a search engine for clinical information.
  • One in three physicians click on sponsored listings
  • Medscape is the most popular platform used for watching professional videos.


Jul 19, 2012

Now Indians Can Compare Prices of Branded Drugs on Mobile Phones

Consumer mHealth is here. There has been a spurt of entrepreneurship in this field and some Indian phone/ mobile based start-ups have been launched over the past couple of years. Mainly, they have been services meant to connect healthcare consumers with doctors via phone (like Ask a Doctor from Vodafone, Mediphone by Religare technologies,  Dial UR Doctor  and Mera Doctor). Most of these tools are voice based and sometimes don't even fit the rigid definitions of mHealth. Further, they are all healthcare professional specific and have pointedly ignored patients in any decision making process.

Not that all mHealth projects in India are in the private sector. The government of India has also been active in harnessing the reach of mobile phones in the country with some projects in Public health like in ensuring treatment compliance in DOTS Program and in healthcare reporting at grass roots level. 

On the other hand, use of mhealth tools to connect Indian pharma industry and the consumer has not really taken off. One exception was the very useful  Drug authentiction tool ps-Connect which has been launched by PharmaSecure. based out of Gurgaon.

The latest mHealth project by the government of India looks to strike at the alleged root of costly medical care : the widely variable costs of branded drugs. The Indian government has taken the initiative to use simple messaging services (SMS) to educate the public on drug prices.
Here is how it works: Once the person sends a text message of the prescribed brand of drug to a particular number from his mobile, he will receive two to three options of the same medicine, along with the price differential. Say, a patient is prescribed a popular anti-infective like Augmentin (GlaxoSmithKline). He types in Augmentin and sends the SMS to the designated number. He would get a return SMS, possibly mentioning Moxikind CV (Mankind), which is substantially cheaper. But sources said that all responses would come with a caution: please consult the doctor before popping the alternative (pill).
The proposed mHealth project will definitely be trashed by medical associations who will look at this intrusion by patient in decisions regarding brands as an affront to their expertise. Nevertheless, this irreversible shifting of the power balance in favor of healthcare consumers has been long in the making. Instead of objecting to such tools, we must look at strengthening the quality of the tool. The only practical objection to such a project would be the possibility of lower quality brands being suggested by this tool. The quality of branded drug can be ensured by having stringent quality checks for the inclusion of any brand in the database which will be created. 

The savings potential of this tool is enormous and inability to ensure quality of database cannot be an excuse. We cannot afford to throw the baby out with the bathwater.
The service, expected to be launched by the government in August, will be available throughout the country.

PS: If you know of any innovative mHealth projects in India, kindly share the link below in comments.

Also see:

Jun 24, 2012

Crowdsourcing Supervision Of Healthcare Delivery Services in India

Hello ? Where is the Doctor ?

The days of free lunches for doctors in government services will soon be over, if this attendance crowd-sourcing becomes the norm all over India.

Thousands of Indian primary health centers (PHC) work without doctors because there are none posted. Thousands more remain idle because the doctor and other medical staff simply remain unavailable. Absenteeism is a very big curse in the delivery of public health services in India. People dependent on the primary health care centers expect that the doctor is absent. Since all attendances of medical staff is verified at the PHC itself and generally by the absentee doctor himself, there has never been an official check on this culture of 'furlough'. A trial of giving supervisory powers to local 'Sarpanch' (village headman) to ensure attendances of medical staff didn't work out as well as hoped for.

Now Technology and crowd sourcing promises to do what no government administration has managed to do yet. Ensure the presence of medical staff on duty. How Mobile Phones Are Repairing India's Broken Healthcare System 
The Indo-Deutch Project Management Society (IDPMS) tracks SMS messages reporting staff absences sent by local patients, and maps the regions and facilities where absenteeism is prevalent. These maps are then made available to locals and policymakers. 

Presently this experiment is limited to Karnataka. But as and when results emerge, this simple system to involve the citizens to ensure the attendances of medical staff at rural PHCs is bound to have a number of effects on the Indian public healthcare setup. No doubt, the idea will be vilified and rubbished by the entrenched bureaucracy and status-quoist medical staff of government services. But this SMS enabled collaborative supervision of public health services can be a very good tool for improving healthcare delivery by making people more involved in ensuring they get the healthcare services they deserve and pay taxes for.

image: www.canada.com

How Doctors Use Smartphone Apps

There is an increasing use of smartphones by all sections of society in India. Villagers and city dwellers alike are hooked onto many multimedia apps, the most popular being Facebook and Youtube. Doctors, too, are avid users of smartphones and medical apps like Epocrates and Medscape.

   See:5 Useful and Free Android Medical Apps


It is always informative to look at trends among doctors in the United States since quite often the same trend is soon repeated among the Urban Doctors practicing in metros like Delhi and Mumbai. With a reverse brain drain of medical experts to India now being the norm, many of the doctors practicing in major Indian corporate hospitals have been trained in the US. And they bring back the current trends to India sooner than was previously expected. Here's a survey on how 266 doctors use smartphone apps (September 2011).
With smartphones and apps quickly gaining popularity in healthcare, there are now thousands of medical apps available in the app store. To illustrate this app overload challenge faced by doctors today, Epocrates conducted some research and created an infographic looking at the numbers – how many apps doctors download, how many they actually end up using regularly and which apps get used most. 
Interesting that 75% of the doctors with smartphones had downloaded more than 26 apps , though the number of apps they use daily was much much less (about 7). And recommendation of a friend/ colleague is the number one reason for trying out new apps.
Mobile App overload for doctors

Jun 16, 2012

Social Media in Healthcare: A Collective Presentation from HealthWorks Collective

Cleveland Clinic ( in partnership with Johnson and Johnson) recently organized the third annual Patient Experience Empathy and Innovation Summit on May 20-22 at the Inter-Continental Hotel & Conference Center on Cleveland Clinic's campus in Ohio. The attendees (from 34 states and 28 countries) represented hospitals, healthcare systems and businesses.This physician/hospital led event strives to bring the missing 'human' touch to medical care.

The topics discussed ranged from use of internet tools in healthcare, personal technology, patient experience, service excellence, physician communication, search engine marketing and more . As expected, Digital / Social Media use in healthcare was an important (and inaugural) session of the conference.It highlighted how healthcare providers can mobilize the power of digital media to make healthcare better, faster, more personal and affordable. It also explored the latest social media technologies and their roles in patient care, research and education.

From the conference, here is presentation from Robin Carey, Chief Executive Officer, Social Media Today. It dissects and quantifies physician use of digital media like cellphone apps, blogs, Facebook and twitter. Also included are some tips on best practices.

You can find many of the presentation posted on their post proceedings page.

Download Free eBook: Internet For Doctors


Over the past 2 decades, the internet has changed the way the world functions. This is specially true for knowledge intensive professions like medicine. From emails to news alerts, networking to evidence gathering : Medical practice is no more what it was 20 years ago.
For newbies, here's our effort to make your first steps online easier.

Just fill out the form below to download our latest flip-book 'Internet For Doctors'. This flip book will introduce doctors to the internet and lists a number of websites they will find useful in their practice. 
Fill out my online form.
Also See:
Doctors' Use of Email and Social Media : Guidelines

Jun 5, 2012

Financial Malpractices and Ethics among Doctors in India : A Survey

It's now slightly more than a week, 8 days in fact, since the scathing interview of the Medical Council of India chief by Aamir khan on national television. The 4th episode of Satyamev Jayate targeting corruption and malpractices amongst doctors in India has ruffled quite a few feathers in the medical profession.



While many have praised the show for daring to take on the 'mighty' doctors, many others have severely criticized the tone and content of the episode. A mulitude of physician organizations have jumped on a band wagon demanding an apoplogy from Aamir Khan.

At Digital MedCom Solutions, we conducted a very short survey (5 multiple choice questions) amongst Indian doctors about what they thought of the "Anti-Doctor Episode". This survey was filled in by 87 doctors. It is meant to take a snapshot view of the immediate thinking in the medical fraternity (n=87) within the first few days after the television show.

  • 81% of the doctors who participated in the survey had seen the TV show. 
  • 45% felt Aamir was unfairly targeting doctors. 
  • 56% doctors knew a professional colleague who indulged in such activities.
  • 40% doctors think Aamir Khan should shut up as he has no idea about a doctor’s life.

The story is still unfolding as the clamour from medical associations demanding an apology is still growing. A few placatory and balanced interviews of well respected doctors by Aamir Khan have also now appeared in the media. As Aamir now clarifies that he didn't intend to tar ALL the Doctors with the same black brush, the dust has far from settled. Be ready for a round two soon.

May 11, 2012

Why Doctors Love To Hate Electronic Health Records


Doctors love to hate electronic health records. Over the years, many surveys have tried to pinpoint the physicians who are more likely to be satisfied by their EHRs. Surveys have found that those in primary care or Internal medicine are generally more satisfied with their EHRs than their colleagues in Oncology or Ophthalmology. Also, solo physicians were the most satisfied and that satisfaction decreased as the practice size grew to 50 physicians. Physicians in 100% productivity-based practices were more satisfied than salaried physicians. 

So what are the top reasons doctors love electronic health records?
1) An electronic record forces documentation of many steps which might be otherwise missed. More thorough documentation of clinical visits leads to less leakage of revenue.
2) In medicine, patient data is the source of all decisions. EHRs make data retrieval easier and thus quality of patient service is enhanced
3) Doctors are no longer tied to their desks and can work from anywhere anytime.

As many doctors will be quick to point out, EHR adoption also comes with a lot of pain-points.
1) There is no guaranteed improvement in productivity. In fact, there could be a loss of productivity in the short term.
2) Some EHRs are badly designed and require too many steps/ clicks for relatively simple documentation procedure, for eg. CPOE.. Sometimes, important data maybe difficult to find.
3) The omnipresent computer monitor and keyboard is not a very likeable third party in the examination room. It is an obstacle to one-to-one relationship building between doctors and patients.

Nevertheless, electronic health records are used widely and are here to stay. Insights into the reasons some EHRs are preferred over others can be an important advantage for many companies in this multi-billion-dollar industry.
You can read the original AMA article here.
Also see:
-How Poor Health IT Implementation Can Hurt Patients : Electronic health records can improve care, but doctors should also be mindful of some health IT obstacles that can be detrimental to patients.
-How To Ease EHR Frustration : EHRs can slow physicians' practices to a crawl, but evidence suggests they ultimately pay off.

May 9, 2012

The Medscapeindia (MSI) Awards 2012 Nominations Are Open


The Medscapeindia was established as an "foundation pursuing a socio-scientific aim" in the year 2010. Medscapeindia serves as a platform that unites doctors for discussion and debate on relevant subjects. And now the inaugural MSI Awards "Recognizing excellence in Healthcare" nominations are open.

Today, the healthcare and medical sector faces myriad problems unique to this niche in India. Ethical guidelines need to be evolved around sensitive subjects such as doctors' communication with patients, pharma-industry sponsored continued medical education (CME), female foeticide, new regulations for fire-safety etc and many more. The Medscapeindia looks to bridge the gap between healthcare professionals and policy making.

Dr. Sunita Dube is the President of The Medscapeindia Foundation.

Apr 6, 2012

The Evolution Of Health 2.0 As A Fundamental Human Right

Healthcare has changed, but this was not a sudden shift. This change from traditional healthcare to Health 2.0 has been a slow drift and it has been creeping on us since 30th April 1945. When the Allies defeated the Axis powers at the end of World War two, a fundamental shift occurred in prevalent human thinking. Power ceased to remain just in a few powerful hands. There was a universal push towards negating authoritarian ideologies.
The Universal declaration of Human Rights set the bar for civilization. A few related articles in the declaration read:
  • Everyone has the right to freedom of movement  (Article 13)
  • Everyone has the right of equal access to public service (Article 21)
  • Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care (Article 25)
The World Health Organization charter also stressed on evolving a more patient and information centric healthcare delivery model:
The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health.with basic human rights for all. 
(via WHO Constitution : pdf)

The American version of individual level, people centric and technology enabled development was widely accepted as the roadmap throughout the world. World leaders worked towards creating a more inclusive and democratic society 

Right to health and patient empowerment were the next logical steps.  The arrival of the Internet in mid 80’s was another watershed movement in the evolution of human thinking. Recently, Social media and wireless devices have started converging in healthcare for patient empowerment. Patient communities, medical forums, collaborative research, mobile medical applications on hand held devices are just some of the ways health care has changed. This recent technology enabled collaborative care model is loosely described as Health 2.0. 

No widely accepted definition of Health 2.0 exists. A wordle image of the Wikipedia article on Health 2.0 throws up the most widely accepted associations of Health 2.0. 
Health 2.0

The most common associations for Health 2.0 are: 
1) Web 2.0 
2) Collaboration between Patients and healthcare providers, Participatory medicine 
3) Use of Technology and Data 
4) Sharing of Information 
5) Use of Internet and digital tools. 

With the ubiquitous hand held devices (like smart phones) and >30% of world’s population being online, the delivery and acceptance of healthcare has also changed. People want to be involved in their healthcare and they expect to be helped in this by healthcare providers and other stakeholders. Numerous apps and websites have made healthcare data rich and participatory. Healthcare delivery now need not be limited to medical visits but can be present 24/7. Health 2.0 has given Hospitals, doctors, pharma companies and patients a chance to combine forces to improve healthcare. In fact, Health 2.0 is just a “nerd”ic expression of the often misunderstood Health Rights. Health rights are broadly evaluated on Availability, Accessibility, Acceptability and Quality of healthcare. And Health 2.0 fulfills all the requirements for being classified as a fundamental health right.

A few common uses of Health 2.0 include medical education, managing a particular disease and sharing of data for research. Health 2.0 simply borrows the principles of a free progressive post World War two society and applies it to healthcare. Health 2.0 is a democratic alternative of the traditional and feudal healthcare delivery system of the older times. 


(this post originally appeared in the April issue of Medicinman )

What do you think of this? Is health 2.0 a step towards health rights?


Related article

Apr 1, 2012

3 Reasons Why Healthcare Professionals Cannot Afford To Give #hcsm a Miss


Practicing medicine is a very personal  experience. Patients don't go to hospitals to buy medicines but to access healthcare services. Healthcare professionals don't deliver a product, but a high quality personalized service.

Current hospital practices have resulted in patients in India classifying any contact with a hospital / Healthcare delivery institute as an anxiety-inducing activity. Hospitals (and doctors) who can overcome this 'communication issue' and engage patients in improving their health are considered better than others.

After Printing Press --> Telephone and Fax --> Internet, digital technologies are now positioned as the most powerful tool for 'Word of Mouth" marketing as well as medical communication campaigns. Social media is an underutilized but very very powerful tool for healthcare professionals. It seems to be another channel of communication ( like Fax and Telephone were once) destined to be rubbished and ridiculed before being accepted by all as a routine practice.
Here are three practical reasons Healthcare professionals need to use social media.
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Why Healthcare Professionals Need To Use Social Media

View more PowerPoint from Neelesh Bhandari

Web 2.0 services like Facebook, Twitter, Blogspot, Linkedin and YouTube  are common starting blocks for most hospitals and healthcare service providers. If you are looking for a specialized Healthcare Social Media professional team comprising of doctors, coders and designers to handle your online ecosystem, send us an email at info@digmed.in.

Mar 31, 2012

Health Tablets Proposed For Public Health In India

India has increased planned expenditure in healthcare to 2.5 % .  While this is a big jump from the previous 1% of GDP, do note that it is about 5% to 10% in most civilized countries. The Indian government is now betting big on technology and eHealth. Faced with shameful data collection practices, health ministry officials are now looking at using Tablets to improve collection of health data and also improve quality of healthcare service provided at peripheral areas. 


In the news almost simultaneously this week were 2 specialized tablets to be used for healthcare service providers in India.


The Kalam-Raju tablet is the result of collaboration between the former President of India, A. P. J. Abdul Kalam, and well known cardiologist Dr. B. Soma Raju of Care Foundation. This Kalam-Raju tablet will help physicians and certified nurse practitioners in rural areas access patient information, diagnostic tools and new treatment procedures. The tablet shall be out within 3 to 6 months.

Also unveiled this week was another  Android based Health tablet, the "Swasthya Slate"  reportedly capable of providing enough information to make clinical judgements. The tablet can record body temperature, conduct ECG, test blood sugar and blood pressure, measure heart rate and also test quality of water. This is the braibchild of Kanav Kahol, a US-returned Indian biomedical engineer and is being dubbed as the first-of-its kind diagnostic tool. Swasthya Slate is likely to be ready for operation in next three months. 

This is a demo of the Swasthya Slate to a class of medical officers in Odisha



Mar 25, 2012

Doctors Need To Plan Out Their Social Media Strategy

The Internet has really changed the way we deliver (and define) healthcare. As Social media becomes a synonym for the internet (much like email used to be once upon a time), Doctors need to take time to create a proper social media policy and plan to provide service through that channel.

Mayo Clinic has always taken a lead in adopting social media for healthcare. Check out this new video from them featuring Farris Timimi, M.D., Cardiologist and Medical Director of Mayo Clinic's Center for Social Media discussing the role and use of social media in health care.


Dr. Timimi shares that meeting the needs of today's patient requires adjusting to the new standard of physician-patient relationship. "I think what we're all seeing is a change in the relationship between patients and providers. The typical compact that we knew 20 years ago, where the provider guided therapy on their own, I think all of us are aware that's no longer the case. There's more and more interest in a shared process. These tools help us reach so many people and make that transition more of a reality. We can reach people everywhere and bring shared interactions to all parts of our practice. That's powerful!"

Mar 22, 2012

It's Early Days, But Unprofessional Digital Behavior Of Doctors Is Rampant


With 32 % of the world population online, the use of social media in healthcare is becoming common place. Very often, the distinction between professional and personal use blurs on social media. Doctors need to be especially careful about maintaining the highest degree of professionalism in their online behavior.

So what are the common examples of violations of Professional online behavior for Doctors? In a survey over 68 medical boards across the United States, Greysen and his colleagues found that the top reported violations were:
  1. Inappropriate contact with patients online (69 percent).
  2. Inappropriate prescribing (63 percent). 
  3. Misrepresentation of credentials or clinical outcomes (60 percent). 

In response to these violations, 71 percent of boards held formal disciplinary proceedings and 40 percent issued informal warnings resulting in serious actions such as license limitation (44 percent), suspension (29 percent) or revocation (21 percent).

Read:

Mar 19, 2012

Global Trends In Lifestyles Are Changing Healthcare Delivery



The world is changing, and so is medical practice. The ubiquitous use of technology, poor dietary practices and a sedantary life is giving rise to a need for a different healthcare delivery mindset.

Check this cool video (after a long long time!)


Population changes, lifestyle diseases, and healthcare spending are forcing changes in how we deliver healthcare today. Barco Healthcare solutions drive efficiency throughout the hospital and help ensure quality care in the decades ahead.

Feb 19, 2012

Wikipedia Is The Most Popular Professional Web 2.0 Tool Among Doctors

Physicians are making increasing use of the social web. A recent study by  Insight Research Group (pdf) looked at use of social web by 300 primary care doctors in the first quarter of 2011, drawing equal numbers from Germany, Italy and the UK.


Here is the gist of the research.
  • The agency found 69% of European physicians said they used some form of social media for work, whereas 85% of them made personal use of social media.
  • Wikipedia to be the most popular destination there. 60% of doctors surveyed said they used Wikipedia professionally.
  • After Wikipedia, the most popular sites were YouTube (used professionally by 18% of respondents ), Facebook (5.7%), LinkedIn (4.7%) and Twitter (1.3%).
Niche professional uses of community resources like Wikipedia, Youtube and Facebook is now finding acceptance within the professional medical circles. With more than 60,000 Indian doctors on Facebook out of an estimated total of 700,000 doctors in India, Expect to see a similar scenario in India within 2 to 3 years.

Feb 1, 2012

Health 2.0 India Is A Grand Success: Highlights


Health 2.0 was finally in India. On 30th Jan 2012, innovations in use of technology in health and healthcare were showcased at this one day event held at New Delhi. Also held was a code-a-thon which saw 5 fantastic apps developed in 6 hours!

Listed here are some of the highlights from the event.

Publicis Healthware International used this event to launch its India presence. PHI is part of Publicis Healthcare Communications Group (PHCG), the largest healthcare communications network in the world. Roberto Ascione, President of PHI showcased their most recent product, Videum.com.


Videum is a global health video portal able to globalize video assets leveraging an exclusive subtitling technology and featuring unparalleled search engine optimization. In a multilingual country like India ( with at least 30 languages spoken by more than a million people each), Videum.com promises to break this very significant barrier to health communication.Videum is a joint venture between Publicis Healthware International (PHI) and dotSUB.

Also shown at Health 2.0 was Kazemill. This innovative tool analyzes tweets to look for 6 common symptoms presented by people suffering from cold and maps them. Tool from McCann Healthcare.


Dr. Anirudh Malpani , an IVF specialist and a keen Health IT enthusiast, presented his HELP initiative, the world's largest free patient education library. You can also view their video channel here.


Ash Damle showcased his very useful MEDgle product for the audience, a personalized medical search and secure private discussion network.


Rajiv Pratap demonstrated the awesome capability of Abzooba, a unique healthcare communication product. Abzooba's Smart Health Information Platform (SHIP) is a collaborative knowledge platform that brings health providers and patients together in an interactive community. Too bad we couldn't find a video to  showcase the outstanding features of Abzooba.

On show was also India's largest healthcare community, mDhil.com . Nandu Madhava, CEO, heads this innovative project which provides health information via online and mobile channels.mDhil averages 5000 video views per day and has more than 150,000 followers on Facebook. Their marketing strategies rely heavily on social media and they are now looking to expand into providing many other types of healthcare information via their varied distribution channels. Do check the mDhil Health channel on Youtube.


Kunal Sinha, CEO, HealthcareMagic.com provided his solution for improving access to healthcare. HealthcareMagic is a portal allowing live interaction between doctors and patients over the internet and on the phone, creating an integrated comparison-shopping environment for health-related products and services.


Other interesting presentations included:
  • The Cheetah Development Project by Dr. Mark Ereth of Mayo Clinic, an innovative initiative where they have boosted the local economy so as to be able to provide healthcare in Tanzania. 
  • Pharmsecure providing ways to authenticate genuine drugs and safeguard patients from fake drugs.
  • Innovative route to culturally sensitive ways of providing HIV Aids information by TeachAIDS
  • Ayurvaid for individualized sustained care across the patient's life-cycle.
  • Health SuperHiway, an integrated cloud based health information network.
  • And the most interesting talk by Mr. Anil Swarup, the architect of India's National insurance scheme, which is "light on the front-end and technology heavy back-end".
Also on display were Mediphone , a call-a-doctor service from Healthfore and some innovative eHealth solutions from Plus 91 Technologies.

Check some tweets  to see the reactions from Tweeple.

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