Posts Tagged ‘electronic health records’

From imagination to reality in less than a century: Telemedicine and Electronic Health Records

Tuesday, March 20th, 2012

1925-feb-science-and-invention-sm-cover

Today, we slip back in time to 1925 and put on our Flash Gordon glasses to speculate about the future, a time when a doctor not only “sees what is going on in the patient’s room by means of a television screen” but also employs a robotic-like instrument called the Teledactyl (Tele, far; Dactyl, finger — from the Greek) to “feel at a distance.”

This image and the story comes from a delightful Smithsonian blog called Paleofuture in a post entitled Telemedicine Predicted in 1925. The post discusses an article by Hugo Gernsback that appeared in the February, 1925 issue of Science and Invention. You can read more about the intriguing robotoic Teledactyl device and Gernsback’s predictions for medicine of the future.
Fast forward to 2010, and we see how remarkably prescient Mr. Gernsback’s predictions were. Courtesy of a blog comment by Christoph Hadnagy, we find this link to a New York Times story on Denmark Leads the Way in Digital Care, in which 77-year old patient Jens Danstrup talks about what it’s like to be a telemedicine patient:

“You see how easy it is for me?” Mr. Danstrup said, sitting at his desk while video chatting with his nurse at Frederiksberg University Hospital, a mile away. “Instead of wasting the day at the hospital?”

He clipped an electronic pulse reader to his finger. It logged his reading and sent it to his doctor. Mr. Danstrup can also look up his personal health record online. His prescriptions are paperless — his doctors enters them electronically, and any pharmacy in the country can pull them up. Any time he wants to get in touch with his primary care doctor, he sends an e-mail message.

All of this is possible because Mr. Danstrup lives in Denmark, a country that began embracing electronic health records and other health care information technology a decade ago.

Adoption of Electronic Health Records in the US
The Centers for Disease Control issues an annual survey on the use of electronic health records in physician’s offices. Last year, partly bolstered by meaningful use incentives in the Affordable Care Act, use grew by 6%. Dr. Elliot King blogs on the EHR increase, noting that:

“In 2011, 57 percent of office-based doctors used electronic medical records/electronic health records (EMR/EHR), according to the CDC. That number compares to the 50.7 percent of physicians’ offices using EMR/EHR’s in 2010 and 48.3 percent in 2009.”

Some physicians are also taking to telemedicine via Skype, FaceTime and other video conferencing services. In Doctors who Skype: Renegades or Heroes?, Jean Riggle looks at the pros and cons of video chat as used by physicians. She notes that there currently aren’t any guidelines for electronic communication between physicians and patients and there there are several important questions yet to be solved:

  • How can these chats be integrated into the patient’s medical record?
  • Can the actual video be captured and inserted into the record or should a summary of the call suffice?
  • How should physicians be reimbursed for the time they spend using social media?

To follow developments in telemedicine, we offer a few sources:
HealthIT.hhs.gov
Federal Health IT programs
American Telemedicine Association
iHelathBeat
Healthcare IT News

Health Wonk Review: Stormy Weather

Thursday, February 3rd, 2011

This dramatic satellite shot from NOAA captures the scope of the blizzard that swept across the country in the last few days. Being snowbound offered our contributing bloggers lots of time to think about all things healthcare, and in that arena, the climate is almost as stormy as the weather. The Florida judge’s ruling against the Health Care Act was much on the mind of several of our bloggers, as was the State of the Union address — both of which occurred since our last compilation. We have a lot of good submissions this week – grab a cup of cocoa to take the chill off and dig in.
Managed Care Matters – Hosting has its privileges, so we kick off this issue with a nod to the blogger who did the heavy lifting last issue, Joe Paduda. One thing we love about Joe is that he is never one to mince words, as evident in this week’s submission, Paul Ryan’s blatant hypocrisy – and the abject failure of mainstream media. Joe takes the Wisconsin representative to task, along with most of his colleagues in the GOP and the mainstream media. He finds today’s hand-wringing over healthcare related debt insincere from the same players who ignored yesterday’s elephant in the room. Also see his related post: If health reform is overturned.
The Apothecary (posted at Forbes) – Avik Roy’s post Florida v. HHS: Why Vinson’s Ruling Might Stand offers a detailed discussion of the four components of Judge Vinson’s Monday ruling, with an emphasis on why the lack of a severability clause might be the key factor in overturning the entire law.
California Healthline – With talk of rolling back the Patient Protection and Affordable Care Act dominating the news, Dan Diamond reminds us that this isn’t the first time that Congress has considered overturning a major health law. He wonders if the battle over the 1988 Medicare Catastrophic Coverage Act and its repeal 17 months later mightn’t hold some lessons for today.
Colorado Health Insurance Insider – Louise Norris suggests that any debate on healthcare should be based first and foremost on facts rather than rumors. She puts on her detective hat in considering whether a Colorado Representative’s vote was swayed by debunked info from an E-mail forward. She thinks the public debate should be informed by a higher standard and offers some clues for spotting suspect chain-mail claims
Disease Management Care Blog – Jaan Sidorov considers Atul Gawande’s recent essay The Hot Spotters and asks if targeted care management is something new? Jann says that while The New Yorker article might garner the glitteratis’ attention, the practice of identifying and reaching out to patients at risk is a standard MO in many commercial insurance plans. “What’s next, Dr. Gawande,” he asks, “discovering that there are machines that use electromagnetic radiation to take pictures of people’s insides?”
Health Affairs Blog -Tim Jost offers an analysis of Judge Vinson’s decision invalidating the Affordable Care Act, while his co-bloggers opine about the implications of the Sate of the Union speech and its aftermath: Kavita Patel on health care and the State Of The Union; Len Nichols who suggests being honest for a change, and Joe Antos with a taste of budgets to come.
Health AGEnda – In his post on the the John A. Hartford Foundation’s blog, Chris Langston poses a good question: Why are Medicare’s innovations more secret than the Joint Strike Fighter?. He champions the idea that we should be more nimble, transparent and collaborative in sharing innovations and improvements in care, particularly in terms of knowledge that we as taxpayers have already purchased.
Health Beat Blog – Maggie Mahar suggests that when it comes to electronic health records, perhaps we should walk before we run. She likens the mad stampede of EHR implementation to a market bubble with too many sellers, too many buyers, and too little information. In light of this, she tackles the question of whether Congress should defund the conversion to EHRs as some are proposing.
Health Business Blog – What makes you sad? For David Williams, it comes down to three words: US biogenerics policy. David makes the case that the debate on biogenerics misses the point: There are better, safer, faster ways to bring down the cost of biotech drugs while preserving incentives for innovation.
Health Care Renewal – Roy Poses makes a strong contribution to this week’s roundup with his post Big Door Keeps On Turning. He lists examples of health care leaders going from government to industry and then back to government again. He asks if this revolving door, with its constant interchange among corporate and government health care leaders, is a sign of how corporatist health care has become and if we can we really expect a cozy corporate leadership class with no fixed loyalty to any organization to put the care of individuals and populations ahead of their personal interests and relationships?
Health News Review Blog – Gary Schwitzer enlists the help of Harry Demonaco, director of the Mass. General Hospital’s Innovation Support Center in turning a critical eye on health screening advice issued by Prevention magazine, which advised readers, “If you haven’t had these cutting-edge screenings, put this magazine down and call your doctor. Now.” This is cited as another bad example of screening madness in US health care journalism, which promotes and fosters screening outside the boundaries of the best evidence.
Healthcare Economist – Jason Shafrin informs us that home health services are among the fastest growing services that Medicare provides. In thinking of reform to control this rise in spending, he turns to MedPAC’s 2011 Home Health Reform Recommendations.
Healthcare Technology News – Rich Elmore and Paul Tuten discuss the launch of pilot projects enabling secure direct messages among healthcare stakeholders in their post about Direct Project implementations taking flight. They offer project details and note that this is a very big deal, as reflected in the related briefing by David Blumenthal (National Coordinator for Health IT), Aneesh Chopra (US CTO) and Glen Tullman (CEO Allscripts) among other federal and industry participants.
healthyimagination – In December, scientists and healthcare professionals shared groundbreaking research an NIH symposium focused on health disparities. Lisa Cappelloni shares some of the novel approaches aimed at eliminating health inequities in her post Advancing Minority Health: New Minds, New Methods.
The Hospitalist Leader – Bradley Flansbaum offers A Hospitalist’s Lament, a thoughtful essay on the issue of end of life care and advance directives. In the light of controversies like death panels and care rationing, he states that our country may be at least a decade or two away from having a sophisticated discussion on this subject. He illustrates the complexity of the surrounding issues through an intriguing exercise conducted with his colleagues.
Improving Population Health – David Kindig is another contributor who listened closely to the State of the Union address, and asks if one could find any mention of population health, public health, or prevention in the speech. While he didn’t hear those phrases directly, he was heartened by the speech addressing two major drivers of health — education and jobs.
The Incidental Economist – Austin Frakt says that cost shifting is not well understood and has become a political football. He sheds light on the topic in the first of a series of posts: Hospital cost shifting: Brief history and possible future.
Insure Blog – As the oft-quoted Andy Warhol line goes, we will all have our 15 minutes of fame. But in the world of insurance, fame may be measured in cents rather than minutes, if Hank Stern’s post about Ceridian’s 2-cent Moment is any measure. In this case, the company made headlines when a cancer patient was denied coverage over a 2 cent shortchange. Or was there more to this story than the headlines? Hank digs a little deeper and offers his two cents on the matter. (Oh, and kudos to Hank & crew for Insure Blog’s 6 year blogiversary – quite the landmark!)
John Goodman’s Health Policy Blog – In his post The Case For Health Insurance, John states that everyone should have access to health insurance, and notes that real insurance involves a pooling of risks. “The insurer must make sure each new entrant to the pool pays a premium that reflects the expected costs that entrant brings to the pool. Otherwise, the insurer won’t be able to pay claims. The business of insurance is the business of pricing and managing risk.”
The Notwithstanding Blog – Genomic medicine, end-of-life care, and rationing are three “hot” areas of medicine and health policy in which much stock is given to the opinion of bioethicists. Our blogger at the Notwithstanding Blog (written by a first-year medical student) says that he has a bad feeling in observing the near-uniformity with which the bioethics establishment has opposed medical advancement and patient empowerment, and uses the lens of public-choice analysis to argue that the deference shown to their prescriptions is at least partially misplaced.
Pizaazz – In his post about how early career physicians use Facebook, Glenn Laffel reviews a study that should give some comfort to those who worry that physicians will misuse the social networking site by failing to protect patients’ protected health information.
Workers Comp Insider – In the niche area of occupational illnesses and injuries, Jon Coppelman demonstrates that some villains contributing to skyrocketing health care costs might lie entirely outside the delivery system. He examines the curious spike in carpal tunnel injuries reported by guards at an Illinois correctional facility in his post John T. Dibble’s Sympathetic Ear.
That wraps up this issue! Next up to bat: Louise Norris at Colorado Long Term Care Insider on February 16!

Cavalcade of Risk, Issue 5

Wednesday, August 2nd, 2006

We are pleased and honored to serve as host for Cavalcade of Risk #5. We could opine at length on the nature of risk – and we often do – but with 20 post submissions ready and rearing to go, we will commence with this week’s roster without further ado. However, we’d be remiss if we didn’t first offer a special thanks to HG Stern at InsureBlog, not only for being the visionary who launched this risk carnival, but also for his gracious and generous assistance in helping us to compile this issue.
The importance of trust – citing a Wharton Business School experiment on the effects of a breakdown in trust, Joe Paduda of Managed Care Matters discusses deception, trust and the healthcare industry, suggesting that complex policy restrictions and limitations may indeed save a buck now, but are likely to further erode trust and backfire over the long term.
Debt collection – Michael Herrin, aka Debt Collection Lawyer, offers sound advice on important steps you should take to ensure collection before the matter even becomes a debt. He also gives us a behind-the-scenes view of collection in his post about a collection attorney’s tools of the trade.
Electronic medical records – Michael Cannon of Cato at Liberty suggests that if we want electronic medical records, we first need to fix the incentives, and opines that ” … when House Republicans plan to vote this week on legislation that would spend your tax dollars to encourage the creation of electronic medical records, it seems like a classic case of one fouled-up government intervention begetting another.”
Corporate security – Wenchypoo discusses the rise of low-tech spying and the shocking ease of breaching corporate security in her eponymous blog, Frugal Wisdom From Wenchypoo’s Warehouse.
Immigrant workers – Peter Rousmaniere at Working Immigrants discusses the immense challenge of verifying employer compliance with immigration laws in a two-part post. Part two.
Personal finance – Kristin McAllister at Making Cents discusses important planning considerations in her post to buy (a home), or not to buy, that is the dilemma.
Emergency care – in a post on emergency care, Bob Vineyard of InsureBlog raises the issue of whether there is a lack of incentives for taking personal responsibility.
Economic systems – Brandon Peele at GT discusses the concept of Namaste Economics, suggesting that it is an evolution of the current Quid Pro Quo Economics.
Appraisals – Joe Klein of Roth CPA uses the recent decision by a tax court in the matter involving The Kohler Company to demonstrate why the choice of the right appraiser can really make a difference when it’s time to pay the IRS.
Hospitals and medications – David Williams of Health Business Blog has a piece of advice: Going to the hospital? BYOMD. He discusses why leaving medication choices to the hospital can be dangerous to your health.
Health incentives – We already knew (or suspected) that lifetsyle choices can help us increase or reduce the risk of disease, or even death. Marcus Newbury of Fixin’ Healthcare reports that a recent Wall Street Journal report demonstrates a financial benefit, as well.
Another take on incentives – Justin at Health Flux offers another take on the WSJ poll about lifestyle choices. He thinks that punishing folks who make unhealthy choices may not be such a good idea after all.
Pandemic Prep – with all the news centered on the Middle east, it’s easy to forget about other risks. Bob Sargent of Specialty Insurance Blog reminds us that there’s a potential bird-flu epidemic looming, and offers some helpful links.
Investing – blogger “frugal” at My First Million at 33 shares some some must-do money saving tips for potential investors, written from an amateur’s perspective. He covers everything from risk tolerance to how often one should review a portfolio.
Credit card fraud – You know all those little stops you make to get gas or a gallon of milk? Jeffrey Srain of Personal Finance Advice shows us that when and how often we make those little convenience stops can trigger bells and whistles at the credit card fraud center.
The politics of gambling – Jason Ruspini of Risk Markets and Politics explains how gambling could be the basis for “predictive markets.”
More lessons we can learn from gambling – Alex Tabarrok of Marginal Revolution explains what roulette wheels and prostate-specific antigen (PSA) tests have in common.
Budgeting tips – Prince of Thrift at Becoming and Staying Debt Free offers a refreshing formula for a personal budget in his post Understanding the Great Misunderstanding
Risky fun – here at our own Workers Comp Insider, Jon Coppelman offers the definitive word on goofing off when it comes to horseplay and humor on the job in analyzing a recent workers comp decision from the Colorado Court of Appeals.
Calling all medical bloggers: we want you
Envision Solutions and The Medical Blog Network (TMBN) have launched the first comprehensive survey of the global healthcare blogging community, a systematic attempt to gather comprehensive opinion and demographic data. from the global community of healthcare bloggers. Learn more about and participate at Taking the Pulse of the Healthcare Blogosphere survey.