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

Thursday, January 24, 2013

For Obama care Anxiety: Record Number Want To Become Doctors

 

Believe it, or Not !

 Med School Applicants, Medical School Applicants, Med School Admissions, Admission to Medical School, Admission to Prestigious Medical Schools

For all of you disgruntled curmudgeon senior physicians telling your offspring not to go into medicine, listen up ! Get your facts straight ! And don’t listen to me, I was wrong !  What was I thinking?

According to Forbes Magazine;

“The number of students applying to medical school rose again this year with applications up 3.1 percent in what a new report described as “healthy gains” in interest in the medical profession.

The Association of American Medical Colleges, which represents the nation’s medical schools and teaching hospitals,said more than 45,000 students applied to attend medical school this year.Meanwhile, first-time applicants, which AAMC executives say is “considered to be a barometer of interest in medicine” set yet another record, increasing 3.4 percent to 33,772 applicants”

 

 

Five Obama care Winners In Second Presidential Term

With the re-election of President Obama, 30 million Americans without health insurance are certainly winners because they will in less than 14 months have access to medical coverage without the threat of a Romney White House pushing for repeal of the Affordable Care Act.

Those in the health industry providing the benefits and services will also be victorious as an unprecedented number of paying customers who have struggled to pay for everything from a hip replacement surgery to prescription drugs get support to buy medical care.

five key winners as the health law’s benefits bring new paying customers in the doors of clinics, hospitals, pharmacies and doctors offices across the country:

1. The health insurance industry. Health plans like Aetna (AET), WellPoint (WLP), Humana (HUM), and others that have acquired a bigger stake in providing benefits to Medicaid patients will certainly reap millions of new customers. About half of the 30 million uninsured will gain access to an expanded Medicaid program. Meanwhile, all commercial health insurance plans including UnitedHealth Group (UNH), Humana (HUM) and the nation’s Blue Cross and Blue Shield plans are already aggressively promoting their brands in the individual and small group market to prepare for broader sales of these policies on state-run exchanges that will begin operating in 2014.

 

2. The hospital industry.   Hospitals will have much less to worry about when it comes to the annual $40 billion tab for unpaid medical bills and charity known as uncompensated care. In particular, investor-owned hospital chains like HCA Holdings(HCA); Tenet Healthcare (THC) and Vanguard Health Systems (VHS) will also win political cover in Washington and in the communities in which they operate where their commitment to charity care has long been called into question.

3. The retail pharmacy chains. From Walgreen (WAG) and CVS/Caremark (CVS) to Wal-Mart (WMT), these chains have pushed beyond simply filling prescriptions into becoming, as Walgreen CEO Greg Wasson says, the home for all of a consumer’s “health and daily living needs.” Given the influx of patients with a pent up demand for health care services, retailers’ efforts to provide more flu shots and other vaccinations through clinics staffed by nurse practitioners will help serve an expected spike in demand for these services from the newly insured.

4. The generic drug industry. Though health insurance companies worry about their ability to control the cost of new customers, they are expected to aggressively push outpatient care and low-cost prescription drugs as a way to keep premiums low. That means generic drugs will have an even more promising spot on health plan preferred lists known as formularies. This will be a windfall for companies like Teva Pharmaceutical Industries (TEVA).

5. The health care workforce. From nurses and doctors to health roles some say have yet to be invented, more workers beyond physicians will be needed to meet future medical needs, particularly in the outpatient care area. Already, universities and their medical schools, nursing colleges and schools of public health and pharmacy are expanding departments or creating new programs to address future health care needs. All are expected to benefit from increased federal investments in education. Philanthropic organizations, too, are expected to compliment these efforts. Just last month, the Robert Wood Johnson Foundation, a long-time advocate for nursing and nurse education, announced its budget for 2013 that will include up to $425 million in grant-making focused on helping “people stay healthy; lowering national health care costs; and improving access to high-quality care, delivered by a diverse and abundant workforce.”   “Whatever issues are the most vexing—responding to AIDS, an unprecedented shortage of nurses, millions of children being uninsured, astounding racial inequalities in health care—these are the issues we’ve taken on,” said foundation president, Dr. Risa Lavizzo-Mourey.

In fact the greatest growth in patient care will be in the outpatient arena, where new professional designations will sprout as medical schools design new curriculum to educate and train health professionals.

Facing unprecedented change in how medical care will be delivered to more Americans, the American Medical Association said it will provide $10 million toward efforts to transform  medical education for tomorrow’s physicians.

American Medical Association president Dr. Jeremy Lazarus said the doctor group will provide $10 million toward efforts to transform graduate medical education for tomorrow’s physicians.

In order to help accomplish these goals;

The nation’s largest doctor group is providing the money over the next five years to fund “8 to 10 projects.

However, despite these hopeful items, there is still reticence in the eyes of the physician trainee workforce.

Despite improving pay and the critical role primary care physicians will play in the future of health care in the U.S., there remains less interest by doctors-in-training in general medicine than specialty disciplines.

The December 5 issue of the Journal of the American Medical Association showing a small percentage of medical residents plan to practice general internal medicine comes as a physician shortage looms and millions of uninsured Americans with a pent up demand for primary medical care are poised to flood doctors’ offices once they gain coverage 13 months from now under the Affordable Care Act signed into law two years ago by President Obama.

If nothing else the next five to ten years will prove interesting with challenges and accomplishments.

Tuesday, January 15, 2013

The Inexact Science of Predicting Digital Health’s Billions

 

Predictions for mobile health applications for 2012-2013 are turning out largely to be true

Neil_Versel_LargeNeil Versell

Mobile Health News (Neil Versell) reports":

“While it does seem as if the prognosticators are getting more accurate, or at least on the same page, forecasting an immature market like mobile health remains an inexact science

All of these forecasts make for great headlines, and you can be sure to see some of these predictions on PowerPoint slides this year as conference speakers try to explain the vast market potential. But whom should you believe?

Just off the presses is the Deloitte Center for Health Solutions’ report, “mHealth in an mWorld: How mobile technology is transforming health care,” which has remarkably similar findings. Deloitte says the same market would rise from $1.2 billion in 2011 to $11.7 billion by 2018, at a compound annual growth rate of 39 percent.

After that point, the reports start to diverge. Transparency Market Research says “monitoring services” accounted for 63 percent of all mobile health revenue in 2012. If the same ratio holds this year, that market segment would be worth $819 million.

Deloitte says the market for wireless health monitoring devices just in the U.S. has doubled in the past four years, to $7.1 billion, and is expected to triple to $22 billion by 2015. That’s apples and oranges, for sure, since wireless monitoring includes not just mobile apps and the devices connected to smartphones, but in-hospital telemetry monitors and other non-consumer items.

  

Alvicor manufactures a remote EKG monitor connected directly to a smartphone with electrodes integrated into the rear of the phone case.

In March 2012, iData Research reported that the U.S. market for patient monitoring was just $3.1 billion the previous year and would grow at a substantially slower rate than others had suggested, to $4.2 billion in 2018. Around the same time, GBI Research reported numbers similar to those of iData Research, though on a global scale.

 

Berg Insight just came out with a study saying that 2.8 million patients around the world were using home monitoring services and devices with “integrated connectivity” at the end of 2012. That means the devices had integrated chips to send data directly to in-home communication hubs or even directly to caregivers over cellular networks, since the figure excludes people using personal mobile phones, tablets or PCs

Berg Insight says this number will grow by 26.9 percent annually to 9.4 million in 2017.

There were about 730,000 cellular-enabled devices in use for remote patient monitoring in 2011 and 1.03 million next year. But expect to see an explosion to 7.1 million by 2017, representing a CAGR of 46.3 percent, according to Berg.

Berg’s raw numbers are still rather small compared to what Deloitte foresees among all “embedded medical monitoring gadgets,” including those that communicate with smartphones, tablets and PCs. Deloitte says there will be 170 million such devices in use around the globe by 2017.

All of these forecasts make for great headlines, and you can be sure to see some of these predictions on PowerPoint slides this year as conference speakers try to explain the vast market potential. But whom should you believe?

 

Monday, January 14, 2013

Meaningful Use

 

HHS is progressing with it’s definitions of what meaningful use is in their opinion. It bears no relationship to how physicians use their EMR, but rather is a data base for HHS to extract data from an HER.

Thus far there has been no mention of how providers, hospitals and or patient will have access too this data.  (Give us our data !) says  ePatient Dave. It certainly would fit the parameters of “Patient-centric healthcare” as the new mantra in quality health care. Perhaps we need to have our patients lobby for that capability.

(David Harlow “The Society also responded to the Committee’s request for information on the use of patient-generated data, endorsing its use, and noting that: “The patient is the most highly qualified expert on his or her own health, and his or her own experience of the health care system.”

iNTERNET AS A BAIC TOOL

More on this later @glevin1 and +digital health space.

M.U. ver 1.0 and ver 2.0 have been released and appear to be stable. M.U. ver 3.0 .

The Society for Participatory Medicine #S4PM  filed comments on the draft Meaningful Use  Stage 3 objectives,

On another front,

patient Dave and Susannah Fox announce that the Pew Internet Research Center is releasing the results of their study, Health Online 2013 today, at 7 AM. I have not yet reviewed it., however here are the basic findings:

Interested providers (anyone who cares for patients would do well to review this report.  The important take-away is that 50% of consumers get information from the internet, and even more significant is how many use Smartphones to retrieve answers.  This will drive development of Smartphone applications for both the iOS and Android phones. all of this will augment your ability to care for patients, however it will require adjustments to the practice patterns for educational material.

 

 

Summary of Findings


One in three American adults have gone online to figure out a medical
condition

Clinicians are a central resource for information or support during serious
health episodes — and the care and conversation take place mostly offline

Eight in 10 online health inquiries start at a search engine 

Half of health information searches are on behalf of someone else

The social life of health information is a low-key but steady presence in

Specific diseases and treatments continue to dominate people’s online
queries

Internet access drives information access 

Since one in five U.S. adults do not go online, the percentage of online health information seekers is lower when calculated as a percentage of the total population: 59% of all adults in the U.S. say they looked online for health information within the past year in American life

Younger adults and minorities lead the way with mobile health information
search

surface3

Half of smartphone owners have used their phone to look up health
information 

Some seek counsel from fellow patients and caregivers

PEER TO PEER HEALTHCARE

Health care reviews have not caught on among general consumers

 

The report is quite detailed and goes beyond the extent of this article with a multitude of tables and survey details.

 

Sunday, January 13, 2013

Too Big to Fail ?

 

The following is a transcript taken from Google Plus "+Health Care Tallk Community

+Mark Browne +Kathi Browne +David Harlow +Mark Taber discussed the proposed ACO movement.     Perhaps I am  jaundiced as far as government inspired modifications to Medicare and organizational imperatives. In 1964 when Medicare began physicians almost unanimously opposed Medicare, not because it was government insurance or intrusion into the healthcare market, but because physicians knew an inflow of federal dollars would fuel increases in healthcare spending.  Physicians knew that modeling the payment system whereby 80% coverage of patient cost created an  ability to bill more and  fueled much of the medical device development.A little known feature of the original Medicare reimbursement was the payment rate was tied to the usual and customary charge of physicians;

New physicians originally set ther reimbursement rate by increasing their charges when they first began in practice.  Often times new physicians would receive higher Medicare payments as compared to established physicians. Physicians and hospitals in the private sector could now offer healthcare to seniors who prior to this had no coverage unless it was included in their pension plan. Uninsured seniors would depend upon the public hospital system.  In 1971 contracting became  legal with passage of the HMO law and prepaid contracting. It took about ten years and by 1981 PPOs and HMOs were epidemic.  Many HMOs went bankrupt and providers were left 'holding the bag'  In many cases local or regional managed care plans were formed with a withhold of 15% or more administered by small groups. This mechanism allowed capitalization of the small entities, using withholds meant to be paid back to providers, and instead used to line pockets when the smaller managed care entity was   bought by much larger entities. Providers were duped by a relatively few unscrupulous organizers who came away with windfall profits.

Other control mechanisms were put in place, such as prior authorization, and Medicare’ switched to allowable charges.

Regardless of these governing actions medical inflation became even worse, far outpacing the increase in GDP overall,

ACOs likely will go the same way as margins dip to near zero and perhaps into the negative numbers. Hospital boards and ACO management will follow the prevailing wisdom, when solvency is threatened. Sell, or merge. The next step within five years will be mergers and outright purchases  of ACOs

The trail leads to government intervention and bail outs of health entities, 'too big to fail".  Sound familiar? Where have we heard this before?

I hate being right about these inevitabilities. Truth is, getting larger does not mean more savings.

I have given in to my worst fears in the middle of the night..

Wednesday, January 9, 2013

HTE AND DTE Become the Levin Internet Media Group LIMG

 

On February 1, 2013 Health Train Express and Digital Health Space will become subsidiaries of "The Levin Internet Media Group. LIMG”

This change expands our already existing service to businesses beyond those involved in health care.  The health division will retain their original brand names.


We want to thank our readers for the engagement in our health care social media publications. Our emphasis has always been on content and our growth is totally organic.

Health Train Express and Digital Health Space will continue to publish as previously.

Festivities to follow. Watch for our Hangout Event on Air coming soon to a desktop, smartphone or tablet near you.

Sunday, January 6, 2013

Telehealth Bill Introduced

 

On December 30th, Representative Mike Thompson (D-CA) introduced the “Telehealth Promotion Act of 2012” (H.R. 6719) in the House to promote and expand the application of telehealth under Medicare and other Federal healthcare programs. The Act would fix two existing barriers to telemedicine in federal health programs that apply to reimbursement and physician licensure. The passage of the bill would extend the benefits of telehealth and mHealth to nearly 75 million Americans.

If passed, the restriction on coverage of services provided by a telecommunication system would be removed for:

  • Medicare and Medicaid
  • CHIP
  • Federal employees health, dental, and vision benefits programs
  • TRICARE
  • Department of Veterans Affairs

No small matter either is the ability for providers to be able to be reimbursed for telemedicine visits. (this however will open a whole new entity to audit and prevent fraud and abuse.). It has been shown already that telemedicine visits actually increase clinic visits for questions, follow-up and determination of treatments for problems unable to be handled via a video conference. Perhaps coupled with remote monitoring and/or robotic remote laboratory testing, it may prove to be worthwhile. Nanotechnology applied to quick paper strip chemical testing may be the answer.

 

Colored water is used to show how liquid wicks along tiny channels formed in paper using a laser, in research to develop a new technology for medical diagnostics and chemical analysis. Silica micro particles were deposited on patterned areas, allowing liquid to diffuse from one end of a channel to the other. (Birck Nanotechnology Center, Purdue University)

Researchers have invented a technique that uses inexpensive paper to make "microfluidic" devices for rapid medical diagnostics and chemical analysis. To demonstrate the new concept, the researchers created paper strips containing arrays of dots dipped in luminol, a chemical that turns fluorescent blue when exposed to blood. Blood was then sprayed on the strips, showing the presence of hemoglobin. (Birck Nanotechnology Center, Purdue University)

Saturday, January 5, 2013

Future-Med for Social Media

 

The saving grace for health care is the constant infusion of new blood into our stressed out system.

A significant number of physicians suffer ‘burnout’, cynicism and frustration with the ever changing environment of health care finance..  Over a forty year career the changes are at first imperceptible, then immense when looking overall at the system.

the medical system is immensely different from when I was a young doctor. Some of it very good, some…leaving much to be desired.

This post is about an incoming generation of pre-med students, designed to increase access to underserved minority populations:

The University of California, in Riverside California will matriculate it’s first medical school class in August  2013. Prior to this UCR Medical School was a combined program with UCLA.

 

C. Richard Olds M.D Dean and Visionary Leader of the University of California School of Medicine  in Riverside California

CSUSB (California State University San Bernadino is hosting it’s first annual pre-med conference for students, parents and other health professionals. sponsored by IEHP, MAPPS, (Medical and Pre-health Student Society)  KAPLAN, and the PRINCETON REVIEW

Greetings!

Join us as we prepare the California State University, San Bernardino campus to host its first Pre-Medical & Pre-Health Conference!! This conference is for all students, advisors, and parents interested in learning about the healthcare professions and who care about making a difference in their communities! The Pre-Medical & Pre-Health Conference, organized by the Medical and Pre-Health Student Society (MAPSS), targets underrepresented students from all colleges and universities interested in pursuing a career in health care. “Touch the Lives of Your Community with Your Passion for Medicine” Conference Information

The fresh faces of young aspiring physicians demonstrates to me our system will do better with a new generation, who will function in a new system. It’s time for we senior physicians to make way and encourage them…it belongs to them, now

None of them will need to be trained in social media…..they invented it.

  • Date: Saturday, January 19, 2013
  • Time: 8 am – 6 pm
  • Location: California State University, San Bernardino 5500 University Ave. San Bernardino, CA 92407
Updates for the conference are continuously being added

A Real Social Media Event…in Las Vegas

 

The  Consumer Electronic Show is an annual exposition and electronic vendor’s delight as well as progressive consumers.

It begins January 8, 2013 and will be held in “sin city”, Las Vegas, NV.

It is well worth including in Digital Health’s Space wrap up for 2012 and the vision for 2013 and beyond.

To whet your appetite for this techno-feast, and to demonstrate the variety of products that will be on display, we've collected nine of the hottest products that we know will be making appearances. Interested in a really smart car, slick new ultra books, or really fast wireless connections? Perhaps you need waterproof earphones, or are looking for a BIG TV set to watch the Super Bowl. Read on to get a taste of what's to come at CES 2013.

Many medically useful devices for medicine are adapted from ‘consumer electronics'.  Even more so now with such examples as remote monitoring blood pressure monitors, glucometers, weight scales, a wide variety of iOS, and Android, made possible and enhanced by general consumer demand and availability in highly visible marketplaces,online at Amazon, Wal-Mart, and other fine virtual shopping malls.

PerformTek Brings Biometrics To Headphones

Valencell's PerformTek biometric system records health and fitness data that ranges from heart rate and speed to the number of calories burned. Licensable to integrate with earbuds, the technology will allow portable music players to provide gym-goers with not only a soundtrack, but also a series of assessments about their performance. Captured data can synch to a smartphone app in real time, which should make tracking progress easy, and armbands and wrist devices are on the Valencell roadmap. The first products should hit the market in Q1.

A new medical device industry has emerged, one which may be regulated and certified by the FDA as well.

Information Week Hardware reports:

CES: Super Bowl For The Tech Industry

Partly a glimpse at tomorrow, partly a tech bacchanalia, and wholly a spectacle, the Consumer Electronics Show, January 8-11, is too large for the Las Vegas Convention Center's 3.2 million square feet to accommodate. More than 3,000 companies display upwards of 20,000 products to ananticipated 156,000 attendees, meaning Sin City's casinos and hotels are as full of Ultra books, tablets and other gadgetry as they are of slot machines and card tables. Even with Apple's indifference for trade shows and Microsoft's scaled-down presence, CES remains the Super Bowl of tech trade shows.

The show is oriented more around consumer electronics than business needs but InformationWeek is there to cover the breaking news. What IT professional's inner geek isn't tickled, after all, by the sight of giant televisions, futuristic concept cars or cameras that let you focus a picture after taking it?

How about this 4K 80 inch television mounted on the wall of your reception area? No more complaints about waiting times:

Plus, the enterprise won't be left out in the cold. One the one hand, there will be no shortage of items destined to be advertised as impulse purchases at a Best Buy checkout counter. On the other, many of the to-be-announced products will factor into lingering questions that affect the workplace, especially in its current, BYOD-driven form. Will the new Ultra books and convertibles threaten the iPod's dominance? How many OEMs are going to embrace new standards, such as 802.11ac and its supercharged wireless speeds? Will Intel make headway in mobile phones?

We may have some answers by the end of CES, but with other, more specific events on the horizon, such as NAB Show and Mobile World Congress, it's possible some queries might persist even longer. But whether it's the maturation of the Internet of Things or whatever Samsung's getting at with its peculiar teaser image of a vertical TV, you can be sure that CES will satiate -- and quite possibly overload -- even the most ravenous followers of new technology.

Waiting between surgical cases or that late patient you are meeting in the E.D. 

Try

 

iThoughtsHD

Your flight is delayed and you're stuck in the terminal for who knows how long. So grab a Cinnabon, break out the iPad and do a little mind-mapping with CMS's iThoughtsHD, an $11 app for organizing ideas, information and random thoughts

Or  how about

Your pager just went off about your patient in the ICU that had a cardiac arrest, you are across town and the freeway is completely blocked by a 16 wheeler that collided with a ‘Smart Car?  Here’s your solution:

Waze

Soon after Apple foisted its lousy iOS 6 Maps app on the public, CEO Tim Cook publicly apologized for the debacle and suggested that Apple users try several mapping alternatives instead. One of those apps was Waze, a navigation tool that uses crowd sourced traffic information to deliver the latest updates on accidents, congestion, speed traps, red light cameras and gas prices in your area. Waze also provides spoken turn-by-turn driving directions, and can reroute you to less busy thoroughfares. On the downside, it lacks other information you may expect from a mapping app, such as walking directions and public transportation schedules. And given its crowdsourcing ways, Waze probably isn't the best choice for sparsely populated rural areas.

If you haven’t had enough here, want to learn more, get yourself over to Las Vegas by Monday, but hurry I will be standing in line….first. What a way to start 2013 !

Friday, January 4, 2013

Apologies Necessary

 

Mea Culpa !

 

We recently did some analytics for Health Train Express and our sister blog, Digital Health Space.  We notice a sharp uptick in the number of duplicate cross posts on twitter, facebook and Google plus.  Yecch !  I know how much I hate that, as I am sure you do.  So we are doing a serious revision of our IT structure.  The past year we have experienced a gradual and encouraging growth in our readership. While not as explosive as Google, our budget is a bit more Spartan.   The blogs are curated by Health Works Collective (thank you Joan Justice ) and Networked Blog. We are experimenting on Pinterest having heard that the demographics there are uniquely “Women” and we want to embrace that community. In fact I see that the majority of bloggers are ladies who love socializing. Women have always been more verbal than men as shown by the fact they excel in language skills at an early age of development.  I know that I cannot out-talk my better half….she will consistently wear me down and ‘win’ the argument.

So five me a week or so before you “unfriend” me, unfollow me, and report me to Google for ‘abuse’, spam, or for being a ‘troll"’. I promise to behave.