The digital health space refers to the integration of technology and health care services to improve the overall quality of health care delivery. It encompasses a wide range of innovative and emerging technologies such as wearables, telehealth, artificial intelligence, mobile health, and electronic health records (EHRs). The digital health space offers numerous benefits such as improved patient outcomes, increased access to health care, reduced costs, and improved communication and collaboration between patients and health care providers. For example, patients can now monitor their vital signs such as blood pressure and glucose levels from home using wearable devices and share the data with their doctors in real-time. Telehealth technology allows patients to consult with their health care providers remotely without having to travel to the hospital, making health care more accessible, particularly in remote or rural areas. Artificial intelligence can be used to analyze vast amounts of patient data to identify patterns, predict outcomes, and provide personalized treatment recommendations. Overall, the digital health space is rapidly evolving, and the integration of technology in health

Saturday, December 29, 2012

What happened in 2012 (that was really meaningful use?)

 

For all of you surgeons and/or proceduralists next time you come out of the operating room, or for the internists, pediatricians and ‘low reimbursement providers” after you have appealed your last round of ‘denials’ This is what has transpired the past year in social media

Note:  This page will be updated hourly, so refresh often…

Yes, Facebook and Twitter are still here but G+ is disruptive technology at it’s best ! Some digital health social media types did not take long to adopt social media and  far less time than to adopt electronic medical records.  And it required no incentiive payments, nor attestation….just plain  fun !

From the surge in social media interest among health consultants, hospitals, and providers alike it is apparent that social media is now part of the health communities. Physicians need to know what it now offers their patients. Hospitals need to know what it offers their patients and their medical staffs.

Medical device developers and sales personnel now interface directly in real time with their constituency.

The presence of  multiple social media communities has stimulated intense competition for platform innovations.

Perhaps some of you physicians have always wanted to be the next “Sanjay Gupta” and have started your own weekly or daily hangout on air using Google plus. Does  your practice have a page on Facebook, Google or a pin on Pinterest ?

Chances are if you don’t know about any of this you don’t have a computer, or perhaps not even electricity.  But you must know that in third world countries, the use of  telemedicine, and telehealth have become the enabler for rural health management.  (and how do they do that without electricity?)  Well, that is another story.

Friday, December 28, 2012

The Health Reform Law and What will Happen to It

 

Some  are jumping for joy and dancing in the halls thinking, “Well I am glad that is over with.” Obamacare is now the   law of the land.

Many in Congress abdicated their responsibility either  by not  reading the  PPACA bill before  voting, or misguided to vote for it by others.

The decision was purely  a partisan decision passed  only because Democrats controlled the congress in both the Senate and the House of Representatives.

The one pervading evil of democracy is the tyranny of the majority, or rather of that party, not always the majority, that succeeds, by force or fraud, in carrying elections.

The History of Freedom in Antiquity, 1877

Close to 50% of the legislature were not enthusiastic about this law. The rights of the  minority were clearly ignored by the  majority, without any  consideration of the impact on the minority 1 .

Click  on   the image

 

In  addition  to the  basic  civics lesson,  there are   many  specifics regarding PPACA, which remain troubling.

A Resistance Movement Rises Against ObamaCare

(Grace-Marie Turner)

“Though approval of the unpopular law stood at only 38% on Nov. 6, the elections were not a referendum on ObamaCare mainly because Governor Romney was unable to prosecute the case against its most despised provisions – the individual mandate, employer mandate and state-run health exchanges – since all were in the law he signed in Massachusetts.

With the election over and no chance President Obama will sign legislation repealing the law, implementation is proceeding. But the ObamaCare Resistance Movement has begun. Some examples:

Congress: “ObamaCare has to go,” wrote House Speaker John Boehner. He said, “There are essentially three major routes to repeal of the president’s law: the courts, the presidential election process and the congressional oversight process. With two of those three routes having come up short, the third and final one becomes more important than ever.” He pledged “vigorous oversight” and said House committees are already conducting investigations of possible improper spending.

Governors: The health law relies on states to expand insurance coverage through Medicaid and to set up bureaucracies, called exchanges, through which new health insurance subsidies will be distributed. Governor Bobby Jindal wrote a letter to the Department of Health & Human Services explaining why Louisiana will not be creating a state ObamaCare exchange:  (“The full extent of damage the [Patient Protection and Affordable Care Act] causes to small businesses, the nation’s economy, and the American health care system will only be revealed with time. The State of Louisiana has no interest in being a party to this failure,” he wrote.

 

At least 21 states have said they definitely or probably will not set up state exchanges, with Ohio, Wisconsin, Maine, Nebraska, South Carolina, Georgia and Indiana most recently joining the opposition.

Businesses: Companies with more than 50 employees are searching for ways to avoid the penalties for not complying with the law’s employer mandate. They must either provide government-approved health insurance or pay a fine of $2,000 for each full-time worker.But companies can escape the fines if they make the painful decision to cut workers to part-time – defined in the law as less than 30 hours a week. (certainly  not an option where unemployment remains   high and shows little real evidence for improvement.

Religious leaders: The Obama Administration’s decision to force employers to provide access to contraception, abortion-inducing drugs and sterilization at no cost to their employees has prompted 40 lawsuits by Catholic dioceses and other organizations claiming it violates their First Amendment protection of religious liberty.

Although churches themselves are exempt, the mandate applies to religiously affiliated hospitals, colleges, charities and social service agencies. Cardinal Timothy Dolan recently said the Catholic Church will “not obey” the Obama Administration’s HHS mandate, a policy he classified as “immoral.”

There are three major   constituencies opposed to implementation of Obamacare; Religious, Business, Governors and Congress

There is  much more to play out in the next 12   months.  The current plan is brittle, subject to much criticism and lack of faith in it’s ability to perform as mandated. “(end quote)

 

1. Tyranny of  the Majority (The phrase "tyranny of the majority" (or "tyranny of the masses"), used in discussing systems of democracy and majority rule, envisions a scenario in which decisions made by a majority place its interests so far above those of an individual or minority group as to constitute active oppression, comparable to that of tyrants and despots.)

 

Wednesday, December 26, 2012

What Happened to 2012 ?

 

It’s that time of the year between  Christmas and the  New Year to assess events of 2012, successes and   failures, and also to predict for 2013.

Which events rank highest  for you ?  Rank them in order,  high to low.

Health Reform

Health Related  Technology

Social  Media

Career  plans and changes

Political events

Economy

Health Train Express is  curating your well thought out answers and will publish results on  December 30, 2013.

Send your opinion   to  Facebook    Google +  Twitter/glevin1   or   email  digitalhheallthspace@gmail.com

 

Friday, December 21, 2012

No Hospital Left Behind

 

Does that sound familiar ?  It should since we had a similar program for boosting educational accomplishments.  The outcome of that program still remains very much in  question. 

Portions of this report are from Kaiser Health News analysis of the records.

It's no longer enough for hospitals to just send a bill to Medicare and get paid.

The nation's biggest insurer is starting to dole out bonuses and penalties to nearly 3,000 hospitals as it ties almost $1 billion in payments to the quality of care provided to patients.

In what amounts to a nationwide competition, Medicare compared hospitals on how faithfully they followed basic standards of care and how patients rated their experiences. Medicare disclosed on Thursday how individual hospitals will fare when the program, created by the federal health law, begins in January.

Surprisingly some of the biggest and most well known hospitals will be penalized based upon their quality of care measures. These measures range from patient surveys, the use of antibiotics prior to surgery, and hospital readmission rates.

In a push to improve quality, Medicare will pay some hospitals more and others, including Boston's Massachusetts General, less.

In many parts of the country, the hospitals that did the best are not the ones with the most outsize reputations, but regional and community hospitals instead. New York-Presbyterian in Manhattan and Massachusetts General Hospital in Boston, both dominant hospitals in their cities, will have their payments reduced.

Other leading names in the hospital industry, including the Cleveland Clinic and Intermountain Medical Center in Utah, will receive bonuses, although not the largest in their regions.

The danger here of course is that the prospective patient will translate economic coercion with either excellence or deficiency of quality of care. This is a cost containment carrot/stick issues.

In all, Medicare is rewarding 1,557 hospitals with more money and reducing payments to 1,427 others, according to a Kaiser Health News analysis of the records. Most hospitals are seeing far smaller changes than Treasure Valley or Auburn. For many, the bonus or penalty is little more than a rounding error on their bottom lines. And while the current bonus/penalty is small, it is scheduled to increase significantly.

It's not clear that the new payment program will significantly improve hospitals. Some studies of similar incentive programs have found that the improvements ended up not being any better than those of hospitals that weren't prodded financially. Nonetheless, the program is here to stay and is going to expand over the next few years, putting more money into play and adding new quality measures, including patient death rates.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

 

Saturday, December 15, 2012

Doctor’s 2.0 in Paris !

 

Doctors 2.0 & You : Funding e-Patient Travel Scholarships.

The organizers of my favorite conference, Doctors 2.0 and You, are looking for people who could help fund the participation of e-patients in the next event this June. Please help if you can! We need a lot of e-patient participants in these events! (e- stands for empowered, engaged, and enabled)

We’re crowdfunding the participation (and travels) of e-Patients to our International Doctors 2.0 & You Conference in Paris this coming summer! This coming summer, we’re expecting patients, doctors, and innovators from over 40 countries and all walks of healthcare to attend..

 

         

 

Register here

 

             Doctor’s 2.0 Blog

 

Doctor’s 2.0 in Paris !

Doctors 2.0 & You : Funding e-Patient Travel Scholarships.

The organizers of my favorite conference, Doctors 2.0 and You, are looking for people who could help fund the participation of e-patients in the next event this June. Please help if you can! We need a lot of e-patient participants in these events! (e- stands for empowered, engaged, and enabled)

We’re crowdfunding the participation (and travels) of e-Patients to our International Doctors 2.0 & You Conference in Paris this coming summer! This coming summer, we’re expecting patients, doctors, and innovators from over 40 countries and all walks of healthcare to attend..

 

         

 

Register here

 

             Doctor’s 2.0 Blog

 

Friday, December 14, 2012

HIPAA, Privacy, No Guaranties,

 

HIPAA, the Health Information, Privacy and Accountability Act, passed in  1996        (several hundred or more pages) was passed to insure the security of your medical data by hospitals, providers, employees and all those who come in contact with your confidential medical records. The Law also has several other provisions, unrelated to privacy and confidentiality.

Old obsolete, but effective way….shred or burn.

Modern Technology has eliminated the paper shredder, and now there are new electronic barriers and locks on data access.

Today criminals (or the government) can access your data from anywhere without breaking into your office or filing cabinets.

 

U.S. Terrorism Agency to Tap a Vast Database of Citizens

Now through a series of unrelated incidents the tide has swept in and  a new and possibly dangerous potential for a ‘seizure’ of your private information without warrants, or judicial approval.

(Wall Street Journal)

Top U.S. intelligence officials gathered in the White House Situation Room in March to debate a controversial proposal. Counterterrorism officials wanted to create a government dragnet, sweeping up millions of records about U.S. citizens—even people suspected of no crime.

Not everyone was on board. "This is a sea change in the way that the government interacts with the general public," Mary Ellen Callahan, chief privacy officer of the Department of Homeland Security, argued in the meeting, according to people familiar with the discussions.

A week later, the attorney general signed the changes into effect.

The Wall Street Journal has reconstructed the clash over the counterterrorism program within the administration of President Barack Obama. The debate was a confrontation between some who viewed it as a matter of efficiency—how long to keep data, for instance, or where it should be stored—and others who saw it as granting authority for unprecedented  government surveillance of U.S. citizens.

The rules now allow the little-known National Counterterrorism Center to examine the government files of U.S. citizens for possible criminal behavior, even if there is no reason to suspect them. That is a departure from past practice, which barred the agency from storing information about ordinary Americans unless a person was a terror suspect or related to an investigation.

Saturday, December 8, 2012

Digitized Doctors, by Dr. Algo

Vinod Khosla

Machines will replace 80 percent of doctors in a healthcare future that will be driven by entrepreneurs, not medical professionals, according to Sun Microsystems co-founder Vinod Khosla. Khosla, who wrote an article entitled Do We Need Doctors Or Algorithms? earlier this year, made the controversial remarks at the Health Innovation Summit in San Francisco, hosted by seed accelerator Rock Health. The article had already touched on some of the points of his keynote speech, however it was at the summit that the investor challenged a room full of doctors to disagree with his argument -- a challenge that was met with silence. (perhaps the doctors in the audience are still comatose after the Supreme Court decision to uphold the individual mandate) or perhaps they do not want to disclose the mounting insurgency of the medical profession.  Or perhaps they are thinking about “Occupy Health and Human Services. 

 

Khosla’s credentials are excellent as one of the founders of Sun Microsystems in 1981 where he became CEO and Chairman. In 1986, he became a general partner of the venture capital firm Kleiner Perkins Caufield & Byers, where he remained through the early 2000s. In 2004 Khosla formed his own firm, Khosla Ventures, which focused on venture investments in various technology sectors, most notably clean technology.

It would probably be wise for Vinod Khosla to butt out of health policy and stick to coding or selling his products from Sun Microsystems and follow our lead, not determine things that are far out of his realm of expertise.(and those are considerable.

With no qualms about offending an auditorium filled with practicing doctors, Khosla went on to refer to common medical practice as being akin to voodoo, saying "healthcare is like witchcraft and just based on tradition" rather than data driven, as he believes it should be. Machine learning, he argues, will be a more efficient, cheaper and more accurate diagnosis tool one day, leading to a replacement of 80 percent of doctors (those in the upper 20th percentile can remain, apparently). At one point, he even compares medical diagnosis to Google's driverless smart car technology, saying that the latter is more difficult to develop than an accurate diagnostics machine.

Khosla has a recognized huge conflict of interest to drive health care in his direction. (note no disclaimers appeared in his talk or literature).

Khosla has had a vested interest in healthcare for some time, having already invested in projects like AliveCor, an iPhone heart monitor attachment that he funded via Khosla Ventures. The investment firm has also poured £600,000 into the development of Cellscope, an app that transforms the smartphone into a microscope used to test for ear infections. With these tools, he is helping the industry edge towards a system that is consumer driven and competitive, where patients have more control and understanding of their own health, thus giving them more space to make informed choices about their treatment. At least this is the goal in the long term, and it's a trend we have been seeing for some time, with even the NHS stepping up and crowdsourcing consumer-friendly heathcare apps. For now, plenty of professionals have already spoken out against Khosla's dramatic proposal. However most of their contentions are based on the less than flattering view of the medical profession he is portraying that says their assistance might be superfluous in transforming the industry.

"Does innovation mean the two guys in a garage who come up with a radical idea or is it possible that innovation is having people with different experiences and points of view looking at the same problem," counters Davis Liu, a US-based GP and author, in his excellent summary of Khosla's speech. "Surely to make healthcare better, technology entrepreneurs must engage with doctors."

"There are some things that may never be codified or driven into algorthims," argues Liu. "Call it a doctor's experience, intuition, and therapeutic touch and listening. If start-ups can clear the obstacles and restore the timeless doctor-patient relationship and human connection, then perhaps the future of healthcare is bright after all… I know healthcare can't simply be solved by smart people in Silicon Valley alone. To solve healthcare we need everyone to collaborate."  We begin our Journey

 

If nothing else, talks such as these do mobilize the base of physicians, nurses and most caregivers who ask, “ Can the algo feel emotion or care ? Can the patient develop ‘transference to the algorithm and it’s hardware wrapping?

 

The Surprising Path Of Artificial Intelligence                                           More background on Vinod Koshla

 

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Monday, December 3, 2012

mHealth Summit at the Gaylord Convention Center

 

December 3-5th, Starting today .  #mhs12

The largest event of its kind, the 4th annual mHealth Summit brings together leaders in government, the private sector, industry, academia, providers and not-for-profit organizations from across the mHealth ecosystem to advance collaboration in the use of wireless technology to improve health outcomes in the United States and abroad. mHealthSummit.  This year (2012) the focus is on mobile health apps. As expected and predicted mobile health and apss have been and will be a developers heaven.

If you are like me you can enjoy regular updates by subscribing.  This year’s summit is being held in Washington D.C. at the Gaylord Convention Center.

Today, Monday 12/03/2012 

On the tweet #mhs12 table of contents: (a sampling of today’s morning tweets)

http://www.complete-digital.com/

http://www.techurself.com/

http://www.disruptivewomen.net/

http://techchange.org/

http://chilmarkresearch.com/

http://startuphealth.tumblr.com/post/36758636894/24-hot-mhealth-companies-featured-at-the-startup-health

 

In addition to the StarUp Health Mobile Health Pavilion, StartUp Health’s CEO Steven Krein will moderate a dynamic roundtable featuring a diverse group of the country’s leading thought leaders in mHealth innovation. The panel will be interactive and be taking questions from the audience.

 

 

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