Digital Medicine: 2010

Dec 13, 2010

The Top 5 Health and Fitness Websites of 2010

The Time magazine has recently published a list of Top 50 websites in 2010.

The point to note in all the medical ( and also non-medical) websites is that almost all websites are directly benefitting the consumer. These are websites which add Value. Most of these websites allow you to use various tools, like Google Maps or online videos, to derive maximum benefits.

Also, all these websites allow creation of Communities. Thus these websites are good community portals, allowing visitors to connect with each other and thus learn more.

Below are the 5 websites from the Health and Fitness category:

Health & Fitness

Keas : Founded by the former head of Google Health, Keas aims to provide tailored health programs for individual users by combining personal medical data with general health advice. Companies like Quest Diagnostics have teamed up with Keas to input personal data, like blood-test results, to the site.
Mayo Clinic : The renowned Mayo Clinic's website keeps its tips legitimate, combining ease of use with sound medical advice. The site offers an encyclopedic index of diseases and a symptom checker to see what that forehead pain could mean.
Exercise TV: On-demand cable channel Exercise TV allows you to get fit with only a laptop and some extra floor space. Every month, the channel's site uploads more than 100 free workout videos. You can pay to download the clips or you can stream them online cost-free.
Fit by Fun : Fit by Fun animates your exercise with illustrated trainers, upbeat music and a community feel, giving you a list of "classmates" currently using the site. The fickle can adjust their workout scenery and sound track. Though many of its classes and services, like progress tracking, require a paid membership, some are free.
Walk Jog Run: Walk Jog Run utilizes Google Maps and community involvement to map out the best routes in your area. Just input your address and user-generated routes will appear, handily mapped out and measured by distance, speed and calories burned.

Read more: http://www.time.com/time/specials/packages/0,28757,2012721,00.html #ixzz180sfCaQa

Health IT Initiatives at USF Health

University of South Floria Health Center has made good use of the health IT stimulus money to push the campaign to go completely Paperless. And then some more.

So now work is done with touchscreen pads and electronic prescribing systems. You can play, view, and download lectures, news, seminars, music and other USF Health-related media on your iPod, Mac, PC or MP3 player. New talent is recruited online via the Center for Transformation and Innovation

A video report on Tampa Bays leadership in Health IT with the Paperfree initiative

USF Health News Center

USF- Health on Social Media

Dec 10, 2010

Social Media and a Medical Practitioner: Guide from 'Down Under'

Research Projects like those carried out by pathoftheblueeye.com as well as by Accenture have pointed out Medscape.com and WebMD.com as the most often visited sites by Medical Professionals ( 50 % of the time spent within health category) as well as non-medicos. Social Media sites showed a rapidly rising 6% of time spent by a large number of people.

Social Media is now being widely used by doctors as well as patients. All doctors even remotely on social media face many ethical and moral questions regarding online physician-patient relationships. So when is it Okay to use social media and when is it Not ?!

Recently, The American Medical association posted some guidelines for Doctors use of social media tools in a professional capacity.

But now we have the Australia Medical Association and New Zealand Medical Association come out with their version on this dilemma. Here is the google document ( a 14 page pdf you can download/ view online). It is one of the most practical and useful guide of its kind online.

Attached: Social Media and the Medical Profession_FINAL with links.pdf

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Dec 9, 2010

Top 10 Medical Breakthroughs of 2010 : Time.com

Top 10 Medical Breakthroughs

Health IT far from Useful Yet.

Health Data remains stuck in silos and needs to be better integrated so as to allow meaningful analysis.

Health IT won't realize its full potential until analytics software can mine EMR databases to identify trends and help clinical leaders refine best practices, but interoperability and patient trust stand in the way. "[S]till unresolved are questions about how patients' records will be handled--and how they want their records handled," Computerworld reports. "Should they be able to opt into a system of shared electronic records, or should they have to opt out? And who will be the owners and custodians of the information--the patients themselves, or the caregivers or facilities that created the data?"Read more at www.fiercehealthit.com

See this Amp at http://amplify.com/u/i0m0

Which Healthcare Workers get Assaulted the Most on-duty?

Healthcare workers get assaulted 4 times more often than any other sector!
Amplify’d from blogs.wsj.com

They looked at government stats and found that while shootings in health-care workplaces are pretty rare, the rate of assaults is relatively high — 8 per 10,000 workers vs. 2 per 10,000 for all private-sector industries. Nursing staff in nursing homes or long-term care facilities, ICUs, psych units and emergency departments are at higher risk, the paper says.

The authors — Gabor Kelen and Christina Catlett, both from Hopkins’s emergency medicine department and its office of critical event preparedness and response — cite a couple of factors that may be behind the higher-than-average assault rate. Among them: physicians are no longer “viewed with reverence,” health-care is increasingly viewed as a business and patients are often frustrated in their dealings with the system. At the same time “societal incivility may have reached new lows,” with some people turning to violence.Read more at blogs.wsj.com

See this Amp at http://amplify.com/u/i0lv

Dec 5, 2010

Hospitals and Doctors to Create the really Useful Apps

A recent report by Research2Guidance predicts that in the near future, creating and distributing medical apps will no longer be the purview of pure tech/creative companies, but trickle down to doctors, hospitals and other health care service providers. And seeing the enormous amount of action in this field, this prediction seems just right!

via imedicalapps.com

See this cool Symptom Checker iPad app by Mayo Clinic.

This is a great free app which provides useful patient information as well as helps propogate additional Mayo clinic services, free as well as paid.

Guidance on self-care strategies as well as information on when to seek care for more than 40 symptoms.
Relevant links to MayoClinic.com, Mayo Clinic's award-winning consumer health information Web site, for more in-depth information on each symptom
Easy access to information on thousands of additional health topics from MayoClinic.com.
Information on receiving care at Mayo Clinic, including the ability to inquire about an appointment at Mayo Clinic locations in Arizona, Florida and Minnesota.

Oct 13, 2010

Free Market Strategies for Health Marketing

Melinda French Gates: What nonprofits can learn from Coca-Cola | Video on TED.com

Melinda Gates makes a provocative case for nonprofits taking a cue from corporations such as Coca-Cola, whose plugged-in, global network of marketers and distributors ensures that every remote village wants -- and can get -- a Coke. Why shouldn't this work for condoms, sanitation, vaccinations too?

Sep 15, 2010

Case Based Learning With Free iPhone/iPad app

Dr Nayana Somaratna,Co-Founder at TTN Testing Technology (Private) Ltd has been working on the beta version of an interesting medical app for iPhones and iPads. The upcoming app is officially named : "Prognosis : Your call"

Prognosis - a fun and totally free iPhone game that lets you investigate, deduce and diagnose real life in minutes. You can also brainstorm and discuss with other players if you are stuck on a tough or rare case.

Contribute your creative ideas and get exclusive access to try the Beta version of Prognosis before it goes live!

Features of the app:
• Medical and Surgical case scenarios based on real patients.
• Quick and fun to play : just a few minutes per case scenario.
• Group discussions about each case.
• Submit your own interesting cases and be credited for them

The app is compatible with iPhone, iPod touch, and iPad. Requires iPhone OS 3.0 or later.

Sep 12, 2010

Mayo Clinic and Social Media : Success Stories

Mayo Clinic has a long history of Innovation. The clinic started as a single, small outpatient facility, and later became America's first integrated group practice, and currently integrates the practice of over 1,700 medical doctors.

In 2010, Mayo Clinic, Rochester, was ranked as the #2 overall hospital in the United States by U.S. News & World Report . The hospital maintains an exhaustive informational website and a very helpful patient portal.

The institution uses Social Media extensively. The Mayo Clinic Center for Social Media, a first-of-its-kind social media center focused on health care, builds on Mayo Clinic’s leadership among health care providers in adopting social media tools. See below a presentation by Lee Aase, Director for Social Media at Mayo Clinic to view a few case studies in the use of Social Media by Mayo Clinic.

CME and Social Media

View more presentations from Lee Aase.

Also see :
How Mayo Clinic Uses Social Media

Sep 7, 2010

What are Patient Portals?

What Are Patient Portals?

Patient Portals are healthcare-related online applications that allow patients to interact and communicate with their healthcare providers, such as physicians and hospitals. Typically, portal services are available on the Internet at all hours of the day. ...en.wikipedia.org/wiki/Patient_Portals

According to the 2009 Industry Survey from HealthLeaders Media, less than 5 percent of hospitals have interactive patient portals. By 2014 however, more than three quarters of hospitals expect to have patient portals. With increasing popularity of available patient portals, a shift to online patient portals as a service for small and medium sized hospitals seems inevitable.

A study published in JMIR concludes:

"Portal group patients demonstrated increased satisfaction with communication and overall care. Patients in the portal group particularly valued the portal’s convenience, reduced communication barriers, and direct physician responses. More online messages from patients contained informational and psychosocial content compared to telephone calls, which may enhance the patient-physician relationship."

Common Features offered by portals:

Scheduling requests - allows patients to request an appointment date. The appointment is then made by office and confirmation sent to patient via secure messaging.

Medication refills - allows patient to request refill on medications

E-Visits - is a non-urgent electronic visit and in some instance can be a reimbursable.

Electronic History taking - patient fills out electronic information regarding visit. This can save time and helps with documentation of HPI and presenting complaints. Thereby improving documentation and reimbursement.

Pre-registration/Registration - Gets the patients medical history and demographics a very efficient way of registering new patients.

PHR (Personal Health Record) - a homepage maintained by patient via the Internet allows patient to take charge of their Health.

Lab results - secure method of transmitting lab results to patients without having to call or send letters.

Secure messaging - allows for electronic consultations quick questions and/or method to blast vital information to patients especially announcements.

Patient education materials - same as above but some offer medical information as well

Bill payments - some portals offer payments via the Internet some offer account information without the ability to pay on line via credit card.

Who offers Portals:

Medfusion - offers a full array of services (patient registration, secure messaging, personal health records, e-prescribing, virtual visits)

Instant Medical History from PrimeTime Medical Software is not a patient portal but can be integrated into one. $50/month.

PrimePatient from Greenway Medical is a Medfusion product that integrates with Greenway's PrimeSuite Electronic Health Record

Medical net systems- turboHX and PHR separate component

Meditab - health care portal and auto check in.

Medisolve - seems limited to patient registration and medical interview.

Medseek - pre-registration, scheduling, secure messaging, eConsults. Seems to be targeted for larger group practices.

RelayHealth - part of McKesson. WebVisits, secure messaging, PHR, eScripts. $125/month per physician

Care Converge patient portal

Optimal care- is a EHR and a patient portal.

References:

http://idealhealth.wikispaces.com/Patient+portals

Patient Portals — The New Platform for Health Communications

Identifying Factors For Success of Online Health Promotion Programs

Background: Online health communication has the potential to reach large audiences, with the additional advantages that it can be operational at all times and that the costs per visitor are low. Furthermore, research shows that Internet-delivered interventions can be effective in changing health behaviors. However, exposure to Internet-delivered health-communication programs is generally low. Research investigating predictors of exposure is needed to be able to effectively disseminate online interventions.

Objective: In the present study, the authors used a longitudinal design with the aim of identifying demographic, psychological, and behavioral predictors of visiting, using, and revisiting an online program promoting physical activity in the general population.

Methods: A webpage was created providing the public with information about health and healthy behavior. The website included a “physical activity check,” which consisted of a physical activity computer-tailoring expert system where visitors could check whether their physical activity levels were in line with recommendations. Visitors who consented to participate in the present study (n = 489) filled in a questionnaire that assessed demographics, mode of recruitment, current physical activity levels, and health motivation. Immediately after, participants received tailored feedback concerning their current physical activity levels and completed a questionnaire assessing affective and cognitive user experience, attitude toward being sufficiently physically active, and intention to be sufficiently physically active. Three months later, participants received an email inviting them once more to check whether their physical activity level had changed.

Results: Analyses of visiting showed that more women (67.5%) than men (32.5%) visited the program. With regard to continued use, native Dutch participants and participants with a strong motivation to be healthy were most likely to continue usage of the program. With regard to revisiting, older participants and highly educated participants were more likely to revisit the program after three months. In addition, positive affective user experience predicted revisiting.

Conclusions: The results suggest that online interventions could specifically target men, young people, immigrant groups, people with a low education, and people with a weak health motivation to increase exposure to these interventions. Furthermore, eliciting positive feelings in visitors may contribute to higher usage rates.

See: Investigating Predictors of Visiting, Using, and Revisiting an Online Health-Communication Program: A Longitudinal Study | Van 't Riet | Journal of Medical Internet Research

Aug 12, 2010

Tackling the Global Population Growth

The world's population will grow to 9 billion over the next 50 years -- and only by raising the living standards of the poorest can we check population growth. This is the paradoxical answer that Hans Rosling unveils at TED@Cannes using colorful new data display technology.

Hans Rosling (born July 27, 1948 in Uppsala, Sweden) is Professor of International Health at Karolinska Institute and Director of the Gapminder Foundation, which developed the Trendalyzer software system.

His talks at TED are one of the most entertaining talks ever on TED, and i suggest you watch his other talks too. You will love them!!

Who Needs Training in Technology Trends?

Aug 4, 2010

Designing Healthy Communities

How do we address public health epidemics like obesity, heart disease, depression, and diabetes? The answer may lie in the environments we inhabit. In Designing Healthy Communities, community leaders and citizens alike construct roads, parks, schools, and offices to transform our lives. (via www.mediapolicycenter.org)

Designing Healthy Communities from MPC on Vimeo.

Listen to a multitude of people responsible for designing infrastructure and awareness programs to make our lives healthier.

NHS Inform- Personalized Health Information Site for Decision Makers

The NHS Information Center is England's central, authoritative source of health and social care information for front line decision makers.
Our aim is to revolutionize the use of information to improve decision making, deliver better care and realize increased productivity.
Find out more about us, our work and our objectives.

Check it out for all sorts of data and information, like:

Ambulances - How many ambulances in any particular district...
Cancer Screening - Prevalence rates..
Immunization - Statistics and more..
Health care workforce - How many are there?
Contraception, and lots more...

NHS adds personalized Health Information Site for Decision Makers

The NHS Information Center is England's central, authoritative source of health and social care information for front line decision makers. Our aim is to revolutionize the use of information to improve decision making, deliver better care and realize increased productivity.

Find out more about us, our work and our objectives.

Check it out for all sorts of data and information, like:

Ambulances - How many ambulances in any particular district...
Cancer Screening - Prevalence rates..
Immunization - Statistics and more..
Health care workforce - How many are there?
Contraception, and lots more...

Jul 20, 2010

Screening for Subclinical Atherosclerosis - Is It Useful?

Atherosclerosis (also known as arteriosclerotic vascular disease or ASVD) is a condition in which an artery wall thickens as the result of a build-up of fatty materials such as cholesterol.

"Screening asymptomatic individuals for subclinical atherosclerosis has the potential to improve cardiovascular disease prevention strategies, but any screening program must yet be proven to prevent actual cardiovascular disease, an editorial viewpoint and commentary suggest."

In the Journal of the American College of Cardiology, Prediman Shah (Cedars-Sinai Medical Center, Los Angeles, California) explains that screening is central to the primary prevention of CVD.

In a related commentary, Michael Lauer (National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA) argues that undertaking such screening has disadvantages, such as over diagnosis, which are often overlooked.

So, what do we conclude?

Also see- Number needed to screen: development of a statistic for disease screening

Jul 9, 2010

Electronic Medical Records - Hosted Vs SaaS

A very simple explanation of what an EMR is and what are the main 2 options of EMRs available.

1) Internally Hosted EMRs - like most famous EMRs, including VistA and OpenEMR

Here, the software is on a client server and is generally cut-off from the outside world. Some of these EMR packages also allow remote computers to log in into the software, thus adding 'web- enabled' feature.

2) Internet based/ Cloud Based EMRs - like Medscribbler

These EMRs reside in the cyberspace and access is via a website login. These services are typically priced based on number of doctors using it / number of patient entries / Periodic subscription fees.

Though the first type is considered more secure, it can be a pain to use. You would need a whole army of technicians to maintain a system like that in-house.The other option, of using a web based EMR provided as a service, would be my choice. It allows for easier to use interfaces (in my opinion), geographically free application (as it can be logged on to from clinic/hospital/home) and less expensive for small and mid sized practices.

Health Technology to Improve Geriatric Care

Eric Dishman is an Intel Fellow and director of health innovation and policy for Intel’s Digital Health Group.

Dishman is recognized globally for driving healthcare reform through home and community-based technologies and services, with a focus on enabling independent living for seniors.

Multi-platform Medical Simulation App Built on Flash Platform

Innovation Mecom developed a simulation for training and marketing of Carina, a medical device. The application is built on top of the Flash Platform using ActionScript3.0 and simulates all the functions of the actual device.

The same application can run in the browser, as a standalone application and on multiple devices. Check out this video for a demonstration of the app running on a variety of devices.

Jul 8, 2010

Open Source + iPad in Surgery

Discovering new innovative uses of iPad in Health care everyday!

This one comes via @Berci

A wonderful match of Open source DICOM viewer coupled with use of touch screen functions of an iPad.

DICOM viewer OsiriX ( an open source imaging software ) helps surgeons to understand the patient's anatomy and cancerous lesion by pinching to zoom, rotating, and changing window level of the DICOM volume data on an iPad through latex gloves.

To Know more, Read

Usng the Mac for Better Surgical Navigation

Jul 6, 2010

Medical Error Rates Reduce Seven Fold with Electronic Prescribing !

There is a growing consensus that the implementation of health information technology should lead to more efficient, safer, and higher quality of care. The ever increasing burden of record keeping, to comply with the numerous regulations, makes shifting to Electronic prescribing a very attractive option.

The benefits of shifting to EMRs and CPOEs are enormous.

Less Paperwork
Better Evidence based care
Better Data collection
and of course LESS ERRORS.

An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a study of 37 million patient records by HealthGrades

"For e-prescribing adopters, error rates decreased nearly sevenfold, from 42.5 per 100 prescriptions at baseline to 6.6 per 100 prescriptions one year after adoption. For non-adopters, error rates remained high at 37 per 100 prescriptions at baseline and 38 per 100 prescriptions at one year.

Illegibility errors were very high at baseline, and not surprisingly, were completely eliminated by e-prescribing (87.6 per 100 prescriptions at baseline for e-prescribing adopters, 0 at one year). Prescribing errors may occur much more frequently in community-based practices than previously reported. This study findings suggest that stand-alone e-prescribing with clinical decision support may significantly improve ambulatory medication safety.

References:

Electronic Prescribing Improves Medication Safety in Community-Based Office Practices. Journal of General Internal Medicine, 2010.

(via)Electronic Prescribing Decreases Prescribing Errors Seven Fold:

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Dec 13, 2010

The Time magazine has recently published a list of Top 50 websites in 2010.

Dec 10, 2010

Dec 9, 2010

Top 10 Medical Breakthroughs

Dec 5, 2010

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