Friday, February 27, 2015

Digital Health...What is?

What is it ?

Digital health has grown from using a simple electronic health care record into a complex set of uses.

How Millenials are re-shaping digital health. This demographic began learning how to code in elementary school. By the time they reach high school or college they are competent in many forms of digital communications.  Many are very familiar with design of computers and their use for many tasks. All have taken examinations using computer testing methods.  Millenials use computers and software just as my generation previously learned to write with a #2 Yellow pencil and a legal size pad. If a #2 Pencil was not available, the fall back was a 

Bic pen 

or a PaperMate pen

Today's millenial physicians use smartphones, tablet pc and in the near future will be using wearables and speech driven input or output. Efficiency has become as important as quality for many reasons.

In Medical School and while training,  millenials used EHRs and became famiiar with health information exchanges.

During the past decade physicians and health personell had to be trained on the job. Now they are enrolled in courses such as the UC San Diego Course on Essentials of HIE.

Those who were early adopters of HIT will bear testimony to the difficulties using immature systems which actually decreased efficiency.

Ten or more years ago there were few physicians using electronic health record systems. The number has grown exponentially in the past five years (2010-2015), fueled by federal incentive dollars. The same applies to Health Information Exchanges.

Constructing Health Information Exchanges was difficult. There were few, if any models. HIEs required legal means for sharing private and confidential patient information.

In California several organizations have grown from a mish-mash of early committees, outlined here .

Health Information exchanges are now performing essential infrastructure activity, without which quality metrics, outcome studies, and administration of accountable care organizations could not take place. Nevertheless it will take time for the system to become integrated and build health community trust.

HIEs have yet to be formally evaluated nor determining "best of breed".  There are as yet many unanswered questions.

RAND: Systematic Review of Health Information Exchange

The 'system' is still evolving, in some cases using trial and error planning.

In our next post we will discuss mobile health, telemedicine, remote monitoring and the anticipated role of the FDA and the FTC. The Federal Trade Commission pre-empted the FDA by sanctioning and filing a cease and desist order against fraudulent claims by 'MELAPP", a smartphone app claimed to be able to identify malignant melanomas.

Phil Bauman whose blog is  

                                 Health Is Social

                      Infusing Social Media into Healthcare

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