Sunday, May 3, 2015
Chronic Disease and Prevention
Chronic Diseases and Prevention are at the top of the list for Startups, according to Mashable
Venture capitalists are evaluating the candidates, and competition will be stiff.
Counsyl Get Started
The genetic testing services provided by Counsyl help people make knowledgeable decisions about their lives. They offers three tests: Family Prep Screen, Informed Pregnancy Screen and Inherited Cancer Screen.
The Family Prep Screen and Informed Pregnancy Screen provide future parents with information about the genes that they will potentially pass on to children; the Family Prep Screen does so before conception whereas the Informed Pregnancy Screen test does so after. Genetic counselors are then available to help the clients interpret their results and evaluate possible next steps.
The Inherited Cancer Screen lets adults know whether they have a high risk of developing breast, prostate, ovary or pancreas cancer. With this knowledge, adults can either get screened earlier and more frequently, or, in extreme cases, undergo preventive surgery.
Excuse the cliché, but regarding health data, knowledge is truly power. Huneo has capitalized on this notion by developing its HuNet infrastructure that stores time series health information that is then available to any HuNet authorized user. Time series data is made up of measurements conducted over a certain period of time, an example being patients' vital signs. This information is usually not stored and consequently lost forever — a problem that Huneo hopes to address with HuNet.
Alzheimer’s disease is the only one of the top 10 causes of death in America that cannot be prevented, cured or slowed, according to the Alzheimer’s Association, but early diagnosis of the disease could help facilitate drug testing and development.
Neurotrack has developed a noninvasive, computer-based test that has the potential to diagnose Alzheimer’s patients three to six years before they show symptoms, thereby allowing pharmaceutical companies to better recruit patients for clinical trials. The company claims its technology will eventually be used as a screening test to help slow and possibly prevent the disease’s progression.
Omada developed its 16-week online Prevent program as a comprehensive lifestyle intervention for people who have a high risk of chronic disease. The scientifically based program is developed to encourage participants to adopt healthier behaviors in multiple aspects of their lives. To do this, the program includes online lessons about topics like nutrition and fitness, as well as a digital scale that tracks results. Health coaches and supportive peers are also there to help push participants through trying moments. The program boasts a retention rate that is often over 75% — a number that Duffy says is well above most face-to-face programs.
With the Virtual Consult service, HealthTap allows patients to connect with its digital community of doctors to get credible answers for any of their health questions and even checklists of healthy habits to maintain. Other helpful services offered by the company include its Concierge program, which helps patients connect with their existing doctors from anywhere in the world via video, phone calls or text messages, and the RateRx program, for which doctors have rated and reviewed certain medications.
With SkinVision’s melanoma app, users can take photos of their moles that the app will analyze for abnormal growth and save and organize so users can track their moles over time for dangerous, potentially cancerous changes. If users want a professional opinion about a mole, they can also share the photographs with their dermatologist.
Wearable technology is having a moment. Companies like Fitbit, Jawbone, Misfitand even Apple are producing their own versions of activity trackers. Lumo goes one step beyond this, though, and not only tracks activity but also corrects people’s posture and alleviates back pain with its most recent product, the Lumo Lift.
Lumo’s first product was the Lumo Back, inspired by the chronic back pain one of Lumo’s founders used to suffer. The Lumo Back is worn around users’ lower backs, and works to reduce back pain by improving back posture. Following its positive reception, the company decided to create another product to reach an even bigger market.
Most of these offerings have yet to be FDA approved for accuracy and/or reliability. The offerings will need to be vetted.
Friday, May 1, 2015
The Evidence Shows IOM Was Right on Health IT and Patient Safety
April 27, 2015, 10:00 am / Andrew Gettinger, M.D. / Chief Medical Information Officer, Acting Director, Office of Clinical Quality and Safety , and
Kathy Kenyon, J.D. / Senior Policy Analyst
The potential for health IT to reduce errors has been a pillar of health policy on patient safety since the Institute of Medicine’s To Err is Human(2000) and Crossing the Quality Chasm (2001). In 2012, in Health IT and Patient Safety: Building Safer Systems for Better Care the IOM found the evidence on the impact of health IT on patient safety was “mixed.” Since then, whether health IT actually improves patient safety has remained an open question.
The nation has seen widespread adoption of health IT as a result of the Medicare and Medicaid EHR Incentive Programs. With that increase in adoption, there should be more and better evidence on the actual impact of health IT on safety. Health IT should raise the floor on patient safety, and the evidence shows that it has.
Institute of Medicine and Health IT in Redesigned Systems of Care
To add perspective, it’s useful to recall that in 2000 the IOM promoted health IT as part of “redesigned systems of care.” The IOM found that the large number of avoidable deaths identified inTo Err is Human could not be decreased by trying harder in the same old (paper-based) healthcare system. The IOM explained, “Health care has safety and quality problems because it relies on outmoded systems of work. Poor designs set the workforce up to fail, regardless of how hard they try. If we want safer, higher-quality care, we will need to have redesigned systems of care, including the use of information technology to support clinical and administrative processes.”
Health IT is not and never will be a “silver bullet” that reduces unsafe conditions, errors, and adverse events. To improve safety and quality, health IT is an important part of delivery system reform and redesigned systems of care. Health IT, when well designed and implemented, is a tool that can help health information flow in ways that allow for improvements in patient health and safety. Whatever the drawbacks to health IT systems, the evidence suggests that health IT has raised the floor on safety. At ONC, we are committed to working with clinicians, health care organizations, and health IT developers who share a commitment to making care safer and better by continuously improving the safety and safe use of health IT.
It is good to know that the evidence, so far, suggests that the IOM was right back in 2000. We should be going down this path. The widespread adoption of health IT has been a clear benefit to patient safety. We need to continue to work on making health IT even better in a redesigned health system with patient safety and quality its first priority.
he Office of the National Coordinator for Health Information Technology (ONC) convenes the first joint meeting of the Health Information Technology Policy and Standards Committees. We intend to spend the day discussing interoperability in the health information ecosystem.
Committee members will hear a final report from the Joint Jason Task Force, an update from the Interoperability Governance Sub-Committee and an interim report from ONC’s Interoperability Portfolio Manager. These presentations mark several months of dedicated work developing a more detailed, shared roadmap to achieve interoperability in this nation, as a means to see that everyone has access to better quality, more affordable care and better health overall.
These conversations follow our release, in June of 2014, of the high-level document Connecting Health and Care for the Nation: A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure. This paper describes ONC’s broad vision and framework to develop a clear pathway towards interoperability. It is intended as an invitation to health IT stakeholders – clinicians, consumers, hospitals, public health, technology developers, payers, researchers, policy makers and many others – to join ONC to develop a defined, shared roadmap that would allow us to collectively achieve health IT interoperability as a core foundational element of a learning health system.
Not withstanding the aforementioned positive findings; the following is a caveat regarding EHR and HIT usage.
Industry Reaction Mixed to Joint Commission's Health IT Warning
A recent Joint Commission sentinel event alert that warned health IT can pose risks to patients has received mixed reaction from stakeholders, Health Data Management reports (Slabodkin, Health Data Management, 4/22).
The alert -- which was issued last month -- stated that EHRs "introduce new kinds of risks into an already complex health care environment where both technical and social factors must be considered."
The alert cited an analysis of event reports received by the Joint Commission showing that between Jan. 1, 2010, and June 30, 2013, hospitals reported 120 health IT-related adverse events. Of those errors:
- About 33% stemmed from human-computer interface usability problems;
- 24% stemmed from health IT support communication issues; and
- 23% stemmed from clinical content-related design or data issues.
The alert recommended:
- Implementing comprehensive systematic analysis of all adverse events to determine whether they were the result of health IT issues; and
- Limiting the number of patient records that can be displayed on the same screen at once (iHealthBeat, 4/1).
Karen DeSalvo, M.D., M.P.H., M.Sc., the National Coordinator for Health Information Technology, discusses her view of the health information technology landscape. She outlines an agenda for her office that includes incentivizing interoperability, “standardizing standards,” and establishing shared expectations and actions around data security and privacy. This post, which also appears on Health Affairs Blog, is based on Dr. DeSalvo’s presentation at the Health Information and Management Systems Society 2015 annual conference last week.
April 10, 2015, 7:29 am / Karen B. DeSalvo, M.D., M.P.H., M.Sc.
The secure, appropriate, and efficient sharing of electronic health information is the foundation of an interoperable learning health system—one that uses information and technology to deliver better care, spend health dollars more wisely, and advance the health of everyone.
April 2, 2015, 12:36 pm / Karen B. DeSalvo, M.D., M.P.H., M.Sc.
The Office of the National Coordinator for Health Information Technology (ONC) is committed to advancing an interoperable learning health system that impacts individual, community and population health. To achieve this goal in the next several years will require collective action from all public and private stakeholders, including consumers and community-based groups outside of what is traditionally considered the expected set of technology and health care entities.
February 3, 2015, 4:47 pm / Karen B. DeSalvo, M.D., M.P.H., M.Sc.
ONC has released a funding opportunity announcement designed to strengthen the health IT workforce and build on work done by the 17 Beacon Communities to innovate health care delivery with the goal of building a learning health system, as outlined in the recently posted Shared Nationwide Interoperability Roadmap. These initiatives are part of the Department of Health and Human Services’ efforts to achieve better care, smarter savings and healthier people.
February 3, 2015, 10:00 am / Karen B. DeSalvo, M.D., M.P.H., M.Sc.
U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell announced this morning an important Office of the National Coordinator for Health Information Technology (ONC) funding opportunity, which is part of a Department-wide effort to achieve the safe and secure exchange and use of electronic health information to improve health and transform care as outlined in the Shared Nationwide Interoperability Roadmap, Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Version 1.0.