Health Care High Tech

Technological advances are one of the things that we all hope will help drive down the overall cost of health care. Electronic medical records (EMRs) are frequently shown by a wide array of studies to cut a huge amount of administrative costs out of the overall equation. Other innovations could be extremely useful as cost cutters once out of the research phase.

CBCNews out of Canada takes a quick look at some of these advances, and also looks at the source. Their conclusion is that the real "cutting edge" of medical tech advancement is occurring in small companies and start-ups. Citing the more adventurous profile of companies that rely on angel investments and the need to maintain revenue streams on the part of larger, established ones, the article then proceeds to put forth a few examples.

Right off the bat, they go to what I consider one of the most important areas of medical tech: electronic medical records.

Philadelphia-based Hx Technologies wants to unlock the power of computer networks (a very '90s concept) and suck costs out of the system by making it easier to transport diagnostic images like CT scans. Amazingly, shuttling these images to doctors for second and third opinions is still done the old-fashioned way — by hand.

[...]Launched in 2000, Hx Technologies estimates that it can eliminate extra tests — and save the U.S. medical system $5 billion (US) to $6 billion a year — by storing medical images so they can be accessed in encrypted form over the Internet.

They then proceed to take a look at some other innovations, including (believe it or not) robot nurses. It is a fascinating view of the cutting edge.

SOURCE: "Hot technology that could change health care" 09/08/08
photo courtesy of Liz Henry, used under its Creative Commons license

Remote Moitoring Device Gets FDA Approval.

Technology is often a topic here on the Health Care Reform Now! blog. Electronic medical records and the coupled aspects of savings and efficiency that they bring to the table are a central part of George C. Halvorson's approach to reform. Today, I would like to talk about a new innovation, one which will help fill in the blanks on medical records, electronic or otherwise.

I am speaking of the Intel Health Guide PHS6000, a nifty little gadget that takes over a lot of the monitoring and communications needs of chronic care. Catherine Paddock over at Medical News Today has a nice little review of the device:

Intel's Health Guide has an online interface that allows clinicians to monitor and manage patients remotely. The interactive device which can be attached to blood pressure monitors and other home based equipment, sends vital sign data to the clinician, shows patient reminders, presents multimedia educational content, and allows patients and clinicians to communicate by video conference and email. It looks like a medium sized chunky laptop with a touch screen.

I think we could be seeing something big kicking off here. Ease of use studies have been underway for sometime now and projections show the gadget hitting the market around the end of this year. Once this and devices like it become commonplace, it should help put a hefty dent in cost of care by eliminating unneeded office visits as well as by providing up to the minute data for treatment.

SOURCE: "Intel's Home Care Remote Monitoring And Communication Device Gets FDA Approval" 07/14/08
Press release photo courtesy of Intel

Transparency: The Government Angle

One of the big issues with American health care is the lack of ability to compare prices and care quality between care providers. As many people step forward in favor of market driven solutions -- a very good idea in many respects -- this sort of information is crucial to making informed decisions about said market. As a matter of fact many of the posts in our archives here on the blog are concerned with efforts to create this sort of transparency. Now the federal government, in the form of the U.S. Department of Health and Human Services, is embracing that stance.

Cherie Black over at the SeattlePI takes a look:

The U.S. Department of Health and Human Services is running ads in both Seattle daily newspapers Wednesday showing consumers how to compare services and quality of care in area hospitals by using a new Web site.

The ads, which are running in more than 50 other newspapers across the country, promote Hospital Compare (hospitalcompare.hhs.gov), a Web site that scores 26 quality and patient satisfaction measures at nearly 4,000 hospitals nationwide.

This should be an interesting website launch to follow. The media blitz should get them a lot of traffic, and I am sure that soon there will be a lot of commentary floating around the net.

Using metrics like price of procedure, volume (how many of a single procedure are performed), percentage of patients who received anitbiotics an hour before surgery, and how many patients received help when they asked for it the site seems to cover a lot of ground. It is exactly this sort of information which can help create the informed market needed for a free market solution to gain traction.

More transparency in health care is a good thing, said Dr. Ed Walker, medical director at the University of Washington Medical Center, and this site shows how physicians are having more open conversations about errors and prevention.

"I bought my last car by going to Consumer Reports and looking at the comparisons," Walker said. "We have a populous who expects us to be like Consumer Reports, and while that may be a bit ahead of our time, we still have a good balance."

Indeed. This is the 21st Century, people are accustomed to being able to look up anything by simply spending a moment at their keyboard. Instant gratification is something that Americans have always had a penchant for. Google and the Internet have brought that attitude to the world of information and people are becoming highly dissatisfied with the delays endemic to almost any interaction with our health care system. In that respect this is a good thing.

But Walker cautioned consumers to realize that no one measure defines a hospital, and some measures can be imprecise. For example, some measures, such as whether patient received antibiotics before a surgery, are easily defined -- there's a surgery checklist to consult or an empty bottle from the pharmacy as evidence. How long a patient had to wait to see a nurse after he or she was called is more subjective.

"How soon a nurse responded is influenced by a lot of things, including how many patients they have at one time," Walker said. "They weigh the needs of the patients simultaneously -- but we should aspire. These are our patients telling us how we're doing, and we should listen to that."

All in all, I expect this to be a major move forward. Only time will show how well they are able to implement and manage this service, but more transparency and more available information are always good things!

SOURCE: "New Web site compares hospital care: Services, costs and patient satisfaction are all measured" 05/21/08
photo courtesy of edans, used under its Creative Commons license

Reform and Technology

It is no secret that much of the discussion about health care solutions hinges on technology. Efficiency improving, cost reducing tech such as electronic medical records are rightfully brought up in any serious debate on the subject.

With that in mind, today I'm going to point you towards a recent piece in ZDNet's healthcare section by Dana Blankenhorn which discusses the application of Moore's Law to medical reform and technology:

Moore’s Law, the idea that technology gets faster-and-faster faster-and-faster, is not applied often enough to health care. Regulation frustrates it, constantly. We want to audit every data transfer, or place expensive hurdles before any improved device.

Moore’s Law is the force behind the biggest trend in health care, personalized health care. Instead of guessing about what you should do based on test results when you get sick, doctors prescribe lifestyle changes beforehand, based on genetic knowledge.

It’s Moore’s Law which enables Google Health to let you have your personal health records, free. And it’s Moore’s Law which enables Microsoft to store and move all a hospital’s records through its Amalga system.

It’s Moore’s Law which enabled the human genome to be decoded early this decade, and is now enabling the start of decoding how genetics codes for proteins.

It is a significant conundrum, and not an unfamiliar one. Complete deregulation of any big business usually has unwanted consequences, but the speed at which the tech advances is orders of magnitude more rapid than attempts at regulation or legislation. Yet it is this rapid advancement creates better options at lower costs.

As our nation struggles to find a workable solution to the current health care crisis, technological advancements consistently present options that can increase systems thinking and efficiency, improve quality of care while driving down the cost of said care, and enable a more preventative approach.

A workable middle ground needs to be created between regulation and scientific advances. As a nation we desperately need it!

SOURCE: "Moore's Law and Health Care" 05/20/08
photo courtesy of Jurvetson, used under its Creative Commons license

Email and Your M.D.

Among American doctors, less than a third use email as a health care tool. Alicia Chang of the Associate Press takes a look at this strange deficiency:

"People are able to file their taxes online, buy and sell household goods, and manage their financial accounts," said Susannah Fox of the Pew Internet & American Life Project. "The health care industry seems to be lagging behind other industries."

Doctors have their reasons for not hitting the reply button more often. Some worry it will increase their workload, and most physicians don't get reimbursed for it by insurance companies. Others fear hackers could compromise patient privacy — even though doctors who do e-mail generally do it through password-protected Web sites.

Once again, we see an example of how embracing Internet technology, even in its most basic form, can improve the overall health care crisis our nation faces. The studies available state that not only is response time quicker from doctors who use email, but it also helps to reduce costly office visits and repeated phone calls.

For example, a 2007 University of Pittsburgh study published in the journal Pediatrics followed 121 families who e-mailed their doctors. Researchers found 40 percent of e-mails were sent after business hours and only about 6 percent were urgent. Doctors received on average about one e-mail a day and responded 57 percent faster than by telephone.

A separate study by health care giant Kaiser Permanente published in the American Journal of Managed Care last year found patients who used its secure Web system were 7 to 10 percent less likely to schedule an office visit. Patients also made 14 percent fewer phone calls than those who did not use the online services.

In Chang's article she adds a human face to the equation: Suzanne Kreuziger, R.N. Kreuziger works for a doctor who chooses not to utilize email. Kreuziger stresses the ability to have a documented virtual paper trail that she can go back to at any point as a key element of why email can be such an incredibly useful tool for both physicians and patients. Being able to simplify basic needs such as asking for prescription refills, setting appointments, and getting medical test results would be a boon to all involved.

She also points out that the complaint on the part of providers that time spent emailing is not billable seems to hold little water as phone calls are also not billable, and take a greater amount of time in most cases. Chang provides a wonderful look at this minor but important aspect of American health care.

It's not the first time the medical field has been slow to embrace technology. When the first telephones became widely available in the late 1800s, doctors were concerned about being swamped with calls.

Would YOU like to be able to communicate with your doctor via email? Share your thoughts.

SOURCE: "It's no LOL: Few US doctors answer e-mails from patients" 04/22/08
photo courtesy of Mzelle Biscotte, used according to its Creative Commons license

IADMD Offers Free Web Sites for Doctors & Dentists

According to a press release dated this morning, the International Association of Dental and Medical Disciplines (IADMD) is headed for the 33rd Yankee Dental Conference with some cutting edge plans. The medical professionals trade group is offering a new membership perk to those who join -- a professionally done, "upscale" website.

“A Web site is a like an office on the Internet and doctors should have flashy, professional and state-of-the-art Web sites,” says Dr. John J. Ryan, president of IADMD.

At the conference, the IADMD booth will be fully wired, so the various Web site design offerings IADMD offers can be displayed.

But it's more than just a giveaway. Connecting doctors of all disciplines to the Internet is the first step in an overall plan to reform the health care system so that doctors of all disciplines can communicate with one another and under one umbrella group.

The IADMD has an ambitious vision statement that embraces health care reform: "...to promote worldwide healing with a doctor-led, non-socialized plan, that does not add taxes or burdens on employers or individuals, and secures every person's right to the highest quality whole-body health care." Of particular note is the fact that IADMD websites will be e-commerce enabled, allowing patients to both pay online and order products from their doctors. The press release also touts the fact that a similar website would cost between five and ten thousand U.S. dollars, plus monthly hosting and administration fees.

The IADMD gets points for transparency. They are very straightforward about the fact that this is not only meant to be a necessary step forward technologically, but also a great way shine a spotlight on their own organization and efforts:

“If this sounds like a steal that’s because it is,” says Dr. Ryan. “People need to know that they are getting a bargain and we're doing it to get attention.”

The IADMD can be found at Booth #2812 and #2813 of the Yankee Dental Conference, January 30 - February 3 in Boston, Massachusetts. If any of our readers make it to the conference please stop by and share your thoughts about the IADMD initiative or other discoveries by posting a comment.

SOURCE: "New Doctor-led Health Care Reform Group All Smiles as it Heads to the Yankee Dental Conference" 01/28/08
SOURCE: "Yankee Dental Conference 33"

photo is a screencapture of the IADMD website's front page

Alegent, MEDSEEK Team Up to Empower The Patient

On January 15-16 decision makers from nine U.S. health care systems met with analysts, technology experts and policy makers in Omaha, Nebraska for Alegent Health's "Power to the Patient," forum. This event is geared toward the development of policies and systems that provide tools and information to consumers in the interest of allowing them to make more informed decisions on health care issues.

The Alegent Health Online Press Room lists the confirmed participants as:

• Aurora Health Care, Milwaukee, WI


• Elliot Health System, Manchester, NH


• Martin Memorial Health Systems, Stuart, FL


• Mercy Medical Center, Cedar Rapids, IA


• North Shore LIJ Health System, New York, NY


• Provena Health System, Joliet, IL


• Sisters of Mercy Health System, St. Louis, MO


• St. John’s Health System, Springfield, IL


• Via Christi Health System, Wichita, KS

According to the press release from MEDSEEK, who are supporting the forum, Alegent will share its proprietary technology and methodology with any health system that sent a representative to the forum. According to Alegent CEO Wayne Sensor, this could be a large step forward in data transparency, electronic medical records, and the application of systems thinking to health care:

"Information technology is at the core of our ability to better serve consumers," noted Sensor. "Whether it’s providing patients accurate pricing and quality information through the Internet, or implementing greater use of it in our practice settings, our experiences in putting information technology to work for the benefit of consumers is something we are eager to share openly. That is what the 'Power to the Patient' forum is about -- helping other health care providers to learn from our mistakes and benefit from our experiences."

The website for "Power to the Patient" lists the objectives of the forum as follows:

• To foster acceptance of transparency among health care providers, resulting in an environment that empowers consumers to make quality health care decisions by the use of meaningful tools and information.
• To help providers begin or progress along their journey to cost and quality transparency by sharing experiences about innovative new access points and the implementation of consumer-driven health plans within the workforce.
• To create an environment where the lessons and ideas of providers in this arena can be shared and discussed.

Alegent is a faith-based health care system with nine hospitals in Nebraska and Iowa. MEDSEEK is an Enterprise eHealth solutions provider focused on connecting information and people in order to provide better care and promote community advocacy.

SOURCE: "Press Release: National Policy Makers and Health Care Executives Come Together to Discuss the Future of Health Care" 01/15/08
SOURCE: "Alegent: Power to the Patient"
SOURCE: "Press Release: Alegent Health Establishes "Power to the Patient" Forum to Focus on Increasing Consumers’ Engagement in Health Care"
photo courtesy of neovain, used under this Creative Commons license