Monday, July 24, 2017

Google Glass is back as X Glass with focus on industry, healthcare – MassDevice

Google Glass was introduced by Google several years ago. Although creating great initial interest it did not create great market demand.


Google glass was the first implementation of a wearable video screen, quickly displaced by Augmented Reality and Virtual Reality. Other hardware devices soon followed, POGOCAM  a video camera easily attached to any eye glass frame.

Google (Alphabet) is reintroducing Glass oriented toward Health Care Applications, and Industrial applications.

Google parent Alphabet (NSDQ:GOOGL) is relaunching its Google Glass smartglasses with a focus on industry and enterprise applications, including healthcare, according to a recent post from its moonshot subsidiary X.

In a blog post from last week, Glass project lead Jay Kothari said that Augmedix, a company entirely formed around Google’s Glass device, had been working with doctors at a number of different facilities to test and implement it system, which it refers to as a “remote scribe.”
The Augmedix system allows for automated note taking during physician consultations, according to the post, allowing for better patient interactions and saved time.
Doctors at Sutter Health and Dignity Health reported that the tech, powered through the Glass device, was reducing health record data entry time for up to 2 hours, and allowing for improved time management, according to the post.
X Glass has partnered with CHI Health, Christiana Care Health Systems, Dignity Health, Eastern Maine Medical Center, Klosterfrau Healthcare Group, Sutter Health, TriHealth and Trinity Health to test the Glass technology, according to its website.
The company has also partnered with medical telepresence developers Hodei Tech and SwyMed, neuroscience-based augmented reality developer Brain Power which aims to support individuals with autism, traumatic brain injury and others and Aira, a company developing assistive programs for blind and low-vision individuals.

Google Glass is back as X Glass with focus on industry, healthcare – MassDevice

Wednesday, July 12, 2017

ONC Set to Address Information Exchange, Compliance Burden


Can too much information and/or data be a bad thing?

Reducing the burden of electronic health records (EHRs) on physicians and promoting health information sharing will be the major priorities of the Office of the National Coordinator for Health Information Technology (ONC) going forward, Donald Rucker, MD, the new national coordinator, told reporters at a news conference today.
Interoperability between EHR systems has long been at the top of ONC's agenda, but the emphasis on EHR usability and lowering the administrative burden on small practices has not. Dr Rucker noted that, along with interoperability, this goal is very important to Tom Price, MD, Secretary of Health and Human Services (HHS). In introducing John Fleming, MD, deputy assistant secretary for health technology reform, HHS, at the press conference, Dr Rucker also observed that Dr Fleming, a former solo practitioner in Louisiana, is the first senior-level HHS appointee "who represents small practices."
Dr Fleming said that he'd heard many complaints from doctors and patients about physicians' inability to focus properly on patient care because of the administrative requirements they had to meet, including EHR documentation. One reason for this regulatory burden, he said, is Medicare's guidelines for documentation of evaluation and  management (E/M) codes, which were formulated in the 1990s, before most physicians had EHRs.
"Now that EHRs are online, we see how the two [EHRs and E/M coding guidelines] create even more problems: we get voluminous, sometimes nonsensical health notes that can be unreadable or make it difficult to determine where the real information is," he noted.
The challenge of improving EHR usability, Dr Fleming continued, goes beyond the technology itself: it also involves the fee-for-service reimbursement system, which forces doctors to document their work in certain ways in order to get paid.
Dr Rucker agreed. "The CPT [Common Procedural Technology] rules were done in an era before computers, so it's time to rethink that," he said. ONC, he added, is working with the Centers for Medicare and Medicaid Services (CMS) to look at how the burden on physicians might be reduced.
However, Dr Rucker noted, CMS has to balance EHR usability against "honest fair payments" to doctors and program integrity. Later, responding to a question from Medscape Medical News, he said, "Part of what [CMS] is looking at is the interaction of the coding system with the provision of care and the burden of documentation."
While he declined to say whether changes in the E/M coding system were being contemplated, he said CMS is considering how it could help developers design smarter EHRs that would make it easier to document visits.

In addition, Dr Rucker said, ONC is looking at ways to ease the burden on practices of quality reporting in the Merit-Based Incentive Payment System (MIPS). "For a lot of practices, this has become a challenge," he pointed out. "At some point, the expense of complying with the quality measures is much greater than the value of the quality measures."
Interoperability between EHR systems has long been at the top of ONC's agenda, but the emphasis on EHR usability and lowering the administrative burden on small practices has not. Dr Rucker noted that, along with interoperability, this goal is very important to Tom Price, MD, Secretary of Health and Human Services (HHS). In introducing John Fleming, MD, deputy assistant secretary for health technology reform, HHS, at the press conference, Dr Rucker also observed that Dr Fleming, a former solo practitioner in Louisiana, is the first senior-level HHS appointee "who represents small practices."

ONC Set to Address Information Exchange, Compliance Burden

Thursday, May 25, 2017

A Diagnosis for Personalized Medicine

Eric Topol M.D., soon followed by Barak Obama coined the term 'personalized medicine' (PMx).  It’s been about 16 years since Genentech launched Herceptin, a drug for breast cancer patients with a specific genetic mutation. At the time, Herceptin seemed to usher in a revolution for how drugs would be developed and patients would be cured.



In that new version of care, drugs could be tailored to a patient’s specific biochemical profile, dramatically improving efficacy rates and reducing the system-wide costs and complications associated with one-size-fits-all medications. For pharmaceutical manufacturers, this approach had the potential to improve sales and profits through a radically new business model: differentiated products for segmented populations (see “A Strategist’s Guide to Personalized Medicine,” by Avi Kulkarni and Nelia Padilla McGreevy, s+b, Winter 2012).


But despite the occasional success story, PMx is largely seen today as the dog that did not bark. With a few exceptions, such as Herceptin, there are few PMx success stories. This is true for several reasons. 


Health insurers remain unconvinced of PMx’s merits. One would expect these companies to push hard for personalized medicine, considering that they are the main beneficiaries of more efficient healthcare. Yet most payors seem to believe that the economic benefits of PMx are relatively small. The few PMx-based therapeutics now on the market are much more expensive than conventional therapies—and the prices don’t always translate to proportionately better outcomes, such as higher survival rates. For example, Bristol-Myers Squibb released a new metastatic melanoma therapy called Yervoy in the U.S. in 2011. Yervoy costs US$120,000, but in Phase III trials, it added only about 3.7 months of survival time.
In addition, many pharma companies have been hesitant to make the necessary investments in personalized medicine. The steep costs required, including best-in-class PMx development and commercialization capabilities, seem out of proportion to the small markets for each drug. Cancer drugs are the exception, but pharmaceutical companies have focused less on the genetic causes of other diseases. That makes PMx a costlier and riskier proposition.


Finally, the reason success stories are so rare is a notable reluctance among physicians to adopt PMx. Medicine is a cautious discipline, understandably, and in some cases PMx requires practitioners to dispense diagnoses and treatments based on complex molecular changes. For example, in the 10 years since Genomic Health launched its pivotal Oncotype DX test, which can determine the recurrence risk of breast cancer and assess the likely benefit of certain types of chemotherapies, it has faced steep resistance from the medical community. Even though Oncotype DX has been proven as medically relevant technology, and been widely reimbursed by payors, analysts estimate that it is used on only half of all eligible patients.
Despite the promise of fewer and less serious complications than toxic chemotherapy using PMx to treat malignancy, they have other and even more serious side effects causing heart, and liver disorders.


There is much more to be done until this methodology enters the main stream.





A Diagnosis for Personalized Medicine

How to Choose the Right Digital Marketing Model

Every time you use a digital tool such as televideo, telehealth and remote monitoring it says something about your medical practice.  Investigate several companies to be certain you have the most useful system for your purposes.



Digital marketing can be as simple as a web site. Or it can be complex.

Modern consumer industries use techniques that seem foreign to health care.  However consumers (patients) are already conditioned to techniques used by retail sales such as  Amazon, Best Buy, or other players.  While foreign to physicians, patients are comfortable with digital media marketing.

It is well worth investigating, and it could mean a difference in the 'bottom line'.  Medicine has become entrapped in commerce.  Just about every vendor your practice interfaces has a digital marketing media presence, from advertising of devices, drug to purchases, and support.

A brief chart outlines a method of deciding what you need in designing your digital marketing media program.

Look at virtually any consumer industry and you’ll see how changes in digital technology are fundamentally altering the way that consumers engage with brands before, during, and after a purchase. Consumers today expect to browse, research, solicit feedback, evaluate, and push the “buy” button at their own pace, and at the time and place—and via the platform—of their choosing. Consumers also continue to engage with brands online after a purchase and to share experiences with one another. Much of this consumer journey is beyond the direct control of companies, and marketing organizations are sprinting merely to keep pace.
The difficulty is that there’s no one set of capabilities that applies universally. Companies must identify what kind of marketing organization they need to make their strategy a success, choose a digital marketing model based on their strategic objectives, and then focus on developing a handful of marketing capabilities that will allow them to bring that model to life and consistently excel.
This requires the physician to use both IT, perhaps social media and marketing techniques already in use.  Eventually the majority of marketing may become digital.  Change is inevitable, the Yellow Pages are long gone as a source of marketing.  Be prepared for change. Even modern new digital methods could be replaced by another innovation.   Keep current with market preferences.  Consumers (patients) will follow market leaders.  They are not going to use outmoded methodology in healthcare.

Four Digital Marketing Models

Strategy& has identified four equally successful digital marketing models: Digital Branders, Customer Experience Designers, Demand Generators, and Product Innovators. A company’s focus for marketing investment might have elements of each, but odds are that one of these models represents the right marketing organization for your company.
• Digital Branders are most often consumer products companies or other marketers that focus on building and renewing brand equity and deeper consumer engagement. 
• Customer Experience Designers use customer data and insights to create a superior end-to-end brand experience for their customers. 
• Demand Generators (typically retailers) focus on driving online traffic and converting as many sales as possible across channels to maximize marketing efficiency and grow their share of wallet. 
• Product Innovators use digital marketing to identify, develop, and roll out new  products and services. 


For more specifics refer to:
 Summer 2014 / Issue 75 (originally published by Booz & Company)





How to Choose the Right Digital Marketing Model