How networking is transforming healthcare

“Internet2, a consortium of 200 U.S. universities, 70 corporations and 45 government agencies, has been applying advanced networking to medical research, education and clinical practice for several years. With its Health Network Initiative, Internet2 is underpinning the Federal Communications Commission’s Rural Healthcare pilot program, which promotes the use of telehealth and telemedicine services nationwide.”

Sounds exciting? I think its a sign of things to come – major improvement on Networking due to new requirements form the healthcare industry.

This article from www.networkworld.com contains excerpts from the conversation between Mike McGill, program director for Internet2’s Health Sciences Initiative and Network World’s Carolyn Duffy Marsan about how he believes gigabit-speed networks can transform the healthcare industry.

The article is pretty long so brace yourself 🙂

Can Pen and Paper Help Make Electronic Medical Records Better?

I chanced upon this interesting article from the Indiana University Purdue University Indianapolis on the results of a new study on the use of the pen and paper workarounds employed by healthcare providers who use an electronic medical record system (pretty reflective of real life eh).

“The results of a new study of the pen and paper workarounds employed by healthcare providers who use an electronic medical record system may help make electronic medical records even more useful to health-care providers and the patients they serve.

“Exploring the Persistence of Paper with the Electronic Health Record” appears in the September 2009 issue of the International Journal of Medical Informatics.

Observing that doctors, nurse practitioners, nurses, pharmacists and others who use electronic health records have not totally abandoned paper, including notes stuck or taped to a computer monitor, index cards, and even notebooks, the researchers, led by Jason Saleem, Ph.D., a Regenstrief Institute investigator and assistant research professor in the Purdue School of Engineering and Technology at Indiana University-Purdue University Indianapolis, documented how and why they were using paper.

“Electronic medical records are instantly accessible to the healthcare team. But so much information is included in an electronic medical record, how does the individual health-care provider pick out what is important at a specific time? Not all uses of paper are bad and some may give us ideas on how to improve the interface between the health-care provider and the electronic record,” said Dr. Saleem, who is also a research scientist at the Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice at the Roudebush Veterans Affairs Medical Center in Indianapolis.

In the study of 20 health-care workers at the Roudebush VA Medical Center, the researchers found 125 instances of paper use which fell into 11 categories. The most frequently cited reasons for using paper workarounds were efficiency and ease of use. Second most frequently was as a memory aid. The third most frequent reason was to recognize or alert others to new or important information.

“Any use of pen and paper workarounds needs to be coordinated with the electronic record because if it circumvents the electronic medical records it creates the potential for medical error,” said Dr. Saleem, a human factors engineer specializing in the delivery of medical care.

An example of use of paper which the researchers labeled as useful was the issuing of pink index cards upon arrival at a clinic to patients who had high blood pressure. The data also was entered into the electronic medical record. The pink cards were passed along to the physician to alert him or her to elevated blood pressure. The study, which was descriptive in nature, did not speculate on whether this alert function could be performed equally as well by the electronic system.

Noting that electronic systems have the ability to alert clinicians reliably and consistently, the study recommended that designers of these systems consider decreasing the overall number of alerts so clinicians don’t ignore them due to information overload.

Authors of “Exploring the Persistence of Paper with the Electronic Health Record” in addition to Dr. Saleem are Alissa L. Russ, Ph.D. and Connie F. Justice, CISSP of the VA Medical Center, Indianapolis and Indiana University, Heather Hagg, M.S of the VA Medical Center.; Patricia R. Ebright, D.N.S., R.N of the Indiana University School of Nursing.; Peter A. Woodbridge, M.D., M.B.A. of the University of Nebraska and Bradley N. Doebbeling, M.D. of the Regenstrief Institute and the Indiana University School of Medicine.

The study was funded by the U.S. Department of Veterans Affairs.

Nintendo DS to offer diabetes care

I’ve mentioned this in several conferences I gave (even though I met with disapproving glares) that while it is important to ensure that the cost for patients is reduced as (one of the tangible) benefits, ‘commercialisation’ of healthcare informatics is important as well because commercialisation will create competition which in turn will ‘raise the bar’ (innovation in possibilities) while lowering cost (lowering cost of production and presence of competitors will translate to more savings to patients).

This article is a remote example of utilisation of commercially available (popular) products that is used for healthcare.

This article from e-health-insider.com shares on how Bayer (a pharmaceutical company) unveiled a blood glucose meter for children with diabetes that connects to the Nintendo DS and DS Lite games consoles (now thats innovative engineering).

“The DIDGET meter from Bayer Diabetes Care links to the Nintendo DS consoles and is designed to help children with diabetes manage their condition by rewarding them for consistent testing and meeting personalised glucose target ranges.

The meter will be available in UK and Ireland and aims to reinforce testing habits by awarding children points that they can use to unlock new game levels and buy items within the game.

John Gregory, professor in paediatric endocrinology at Wales School of Medicine, Cardiff University, said the DIDGET meter could ease the tension between parent and child that testing created by adding an element of fun and rewards to the routine,

He added: “Because it is designed with children in mind, Bayer’s DIDGET meter can transform a child’s blood glucose testing experience from something they have to do into something they want to do.”

Sandra Peterson, head of Bayer Medical Care, said that until now blood glucose monitors have been created with adults in mind, adding: “This product was inspired by a parent of a child with diabetes to directly address the challenges facing kids with diabetes and their parents.”

Bayer said the DIDGET meter, intended for use by children aged five to14, would also connect to Bayer’s DIDGET World, a new password-protected web community where children will be able to spend points that they earn from consistent monitoring practices as well creating their own page. The company said the site was in development and would be available soon.”

Smart clothes for better healthcare

This takes tele-patient monitoring to the next level 🙂

“Comfortable smart clothes that monitor the wearer’s heart, breathing and body temperature promise to revolutionise healthcare by reducing hospital visits and allowing patients to lead more active lives.”

Sounds like something from a science friction movie or academic vision eh, well its not, there is a health-wear project that is capitalising on the advancements in e-textile and mobile telecommunications technologies for the development of new services with applications in health-care (The shirt, sweater, coat can be a computing devise).

Do read the original article from ICT Results if you are interested (they have a nice video demonstrating the actual smart clothes).

Telehealth monitoring cuts heart failure readmissions by 54%, $20K per patient

“Heart disease is the leading cause of death in the United States and is a major cause of disability. The most common heart disease in the United States is coronary heart disease, which often appears as a heart attack” (Source : www.cdc.gov)

Sounds terrible isn’t it? My present (day) job is working on cardiology informatics and it made me realised that anyone (in the modern environment)  can be subjected to the pains of heart disease (sometimes, its the family that suffers).

This article from www.cmio.net brings some news;

A home telehealth monitoring program developed by the University of Ottawa Heart Institute (UOHI) has cut hospital readmission by 54 percent for heart failure patients. The program also has been shown to save up to $20,000 for each patient safely diverted from an emergency department visit, re-admission and hospital stay.

“Heart failure is a growing burden with substantial healthcare costs that we can reduce through prompt intervention. A very common problem is compliance among patients who leave hospital then stop taking their medication. They get sick again, arrive at the emergency room and end up back in hospital,” said Christine Struthers, advanced practice nurse of cardiac telehealth at UOHI.

More than 500 heart failure patients have been followed by UOHI since 2005. Each day, patients measure and send their vitals signs — from weight to heart rate and medication side effects — to the Institute. The Institute also employs an automated calling system that reaches out to patients for surgical follow up, heart failure and coronary conditions ranging from chest pain to heart attack.

To evaluate home monitoring, the researchers tracked 121 heart failure patients in 2007-2008. Of these, 69.4 percent were readmitted at least once in the six-month period before being followed by telehealth monitoring. They found that readmission fell to 14.8 percent in the six-month period after the patients were tracked via telehealth monitoring — a drop of 54 percent.

Patients are followed by UOHI for up to three months after they are discharged. They check and transmit their measurements daily at a prearranged time and data is transmitted by telephone to the Central Monitoring Station at the Institute. A nurse will respond immediately if any information is questionable or if a patient calls for help.

The Institute program provides daily remote nursing supervision for people with severe conditions. First developed for regional use, the Institute said its cardiac telehealth services now support nearly 1,200 patients from British Columbia to Newfoundland and Labrador, along with satellite sites in 13 hospitals in the Ottawa region.

The beauty of effective implementation of technology in healthcare, and we are not done yet 🙂

Intel adds to patient monitoring system

I blog about “Intel enters healthcare arena with patient-monitoring device” back on the 14th Sep 2008 and am happy to provide an update (taken from HealthImaging.com).

“Intel has enhanced the Intel Health Guide by adding additional connectivity options to the patient monitoring system.

The system is now available with multiple connectivity options including cable/DSL broadband, cellular wireless and residential phone service.

In-home care and health services organizations such as Providence Life Services in Tinley Park, Ill., Spectrum Medical in Portland, Maine, and ProActive Healthcare in San Jose, Calif., are incorporating the Intel Health Guide into their offerings, according to the Santa Clara, Calif.-based company.

The Intel Health Guide allows healthcare providers to customize care, gather information about the status of their patients and collect and prioritize patient data. The company said that the system engages patients in their own care by providing them with a way to have interaction with their care providers and receive relevant self-care education.”

Makes sense doesn’t it?

Microsoft seeks imaging industry input

This is an article I caught off HealthImaging.com, in addition, Representatives from Microsoft has posted this into several industry usergroups and forums; Microsoft’s personal health record (PHR) product – HealthVault, is seeking comment from the diagnostic imaging IT development community on its initial draft design for medical image data types.

Aimed to provide answer around the utilization of DICOM c-FIND, XDS-i support as well as a selection of medical image study and series type DICOM tags. The firm is looking to be able to allow the transfer and storage of existing medical images to the HealthVault PHR.

According to Microsoft, “the image data stored using this data type will be large in both quantity and size and our current XML storage approach doesn’t optimize for binary content like images. To help mitigate this, HealthVault provides separate binary storage we call blob storage (blobs). Each instance of data in HealthVault can also include a blob of additional data and with the introduction of this data type, the HealthVault platform will support multiple named blobs per data instance.”

The draft design is open for inspection and comment at: http://blogs.msdn.com/healthvaultdatatypes/archive/2009/07/09/for-review-medical-image-study.aspx

Prospective ECG Triggering During Chest CT Cuts Radiation Dose

ECGs and Medical Imaging (especially Ultrasound and General X-ray) are two of the most commonly utilised procedures for health assessment purposes so it comes as no wonder that the two different ‘disciplines’ can come together to cut radiation does during a chest CT procedure.

According to this article from Imaging Economics.com, when non-specific chest pain is being urgently evaluated with whole-chest multi-detector CT, using prospective electrocardiographic (ECG) triggering instead of retrospective ECG gating can reduce the radiation dose by more than 70%.

Interested in findout out more, surf on to Imaging Economics.com for the full article.

Regards

Viewpoint: The Joining of Two Worlds

I chanced upon this really good article titled “Education closes the gap between radiology’s clinical and clerical staffs” By Arturo Hiyagon.

Its a long article so I will not repost it here, you can read it from RT-Image here.

Citing just the abstract – “Learn from someone who has worked on both the clerical and clinical sides of radiology how better patient care and efficient workflow can be attained through increasing the administrative staff’s knowledge and awareness of radiology techniques, procedures, and terms.”

Sounds familiar? It works for PACS Administrators who are not of a radiology background 🙂

Intel, GE Form Health-Care Alliance

Intel Corp. and General Electric Co. announced an alliance to develop and sell technology to help care for the elderly and chronically ill in their homes.

Intel Chief Executive Paul Otellini and GE Chief Jeffrey Immelt Thursday pledged to invest more than $250 million over five years on research and development associated with the effort.

Among other things, GE will sell and market a system called the Intel Health Guide, which is designed to help patients to track their health and provide data about their conditions over the Internet to doctors

To read more, surf on to The Wall Street Journal