Let's Hear it for Google Glass !

Indian physicians are often on the 'cutting' edge' of developing technology. Especially surgeons (no pun intended)  

OK, Glass, say docs at city hospital’s operation theatre

One of our social media gurus #kathibrowne of Health Talk Community group on Google + while visiting India had a glass glimpse of how surgeons are adapting Glass. Formal training sessions with Glass and  Doctors in Bangalore will soon make wearable technology a permanent feature of their surgical attire — several surgeons at Sri Sathya Sai Institute of Higher Medical Sciences at Whitefield are being trained to perform surgeries wearing Google Glass.

Will this new technology be integrated into medical training here in the United States?  Like most innovations in surgical technique a few brave doctors will begin using Glass.  If it proves to be effective, reduce operating room time, improve outcomes, and yes maybe even save money, the early adopters will begin formal 'skills' courses at national meetings.

Kathi Browne, a healthcare-focused social media consultant from the United States who helped co-ordinate the Google Hangout on Air for the three-day ASEF project in Bangalore, said hundreds of doctors were trained by representatives of the Google Glass community for healthcare, thereby turning them into Google Glass 'explorers'. 

Kathi, who specialises in using Google Glass and other contemporary tools in healthcare, told Bangalore Mirror, "In addition to recording a live operation, Google Glass also helps to access medical records online or through the intranet. In case of a doubt one can stop the procedure and take advice and consultancy from other physicians during a surgery." 

Google glass eventually will become a main stay in many industries for education, training and archiving events. 

The next application may very well be in law enforcement, adding to the 'dash cam'.

Why some docs will 'just say no' to MU

'This disruptive need to fulfill meaningful use criteria interfered with my ability to care for my patients'

August 8, 2014

Thousands of eligible providers are working diligently toward EHR incentive payments, but some practices are choosing a different route: abandoning meaningful use altogether in favor of their own solutions, and finding ways to make up for the penalties they’ll incur down the road.

Some 6 percent of physicians, in fact, will be “abandoning meaningful use after meeting it in previous years,” according to the Medscape report on EHR use in 2014. In surveying nearly 20,000 doctors, Medscape found another 16 percent admitting that they would never be attesting to meaningful use in any capacity. 

And although those numbers may seem small now, chances are they won’t stay that way for long as MU requirements become progressively more stringent, said Art Gross, CEO of HIPAA Secure Now.

Technophobia isn't the issue

Providers pushing back against the MU system aren't your typical renegades. They don't have an overall disdain for regulatory expectations and they aren’t opposed to the technologies and ideals fueling MU requirements. What they do have is a concern that patient service may be compromised by the demands of the mandate.

"This disruptive need to fulfill meaningful use criteria interfered with my ability to care for my patients, and despite the consequences, I stopped (attesting)," said James Legan, MD, a Montana-based physician who has opted to pay MU penalties.  

Legan said the decision has opened up his practice to a whole host of opportunities that would have been overlooked otherwise.

"By not being encumbered with the process of MU, I decided to try out new technology to improve efficiency to offset the significant cost of the penalty," Legan said.

These technologies included patient portals and a Chromebook workaround that enables EHR projection and presentation, which have both contributed to "a significant improvement in workflow and patient satisfaction."

"I have had the time and freedom to do two extremely transforming paradigm shifting maneuvers in the office, which make the meaningful use incentive and penalty meaningless because, first and foremost, I was able to cater to what was best for my patient and, as a result, it has been very productive," Legan explained.

Not for everyone, but definitely for some

But while Legan has been able to find value without meaningful use by integrating individual technologies such as the Chromebook front-end and a faxing/portal solution, he admits that the penalty route may not be for everyone.

"Unfortunately, unless you are in a small office setting and call your own shots, this solution may be difficult to mimic," Legan said. "Nonetheless, I am practicing at a level I never imagined possible just a few years ago when taking the blind leap into the realm of the electronic record."

Whereas Legan’s approach may look like trailblazing at the small practice level today, Gross expects that others will follow suit in due time.

Early indicators from the Centers for Medicare & Medicaid Services suggest he could be proven right. On Wednesday, CMSrevealed the latest attestation rates for Stage 2 of meaningful use and while the 1,898 eligible professionals and 78 eligible hospitals that have attested to Stage 2 as of July’s end are up slightly since last month’s paltry numbers, they do trigger questions about when we may start to see attrition away from meaningful use.

"I don’t think we’ll see the big push in dropouts until next year or the following year," Gross said, "because it does get harder and harder."

Topics: Meaningful use, Electronic Health Record (EHR), Workforce Management, Patient portals, Medicare, Medicaid,Centers for Medicare & Medicaid Services (CMS)

Frontiers in Medicine 2014

Digital Health Space explores innovations in Human Resources and Medical Education for Primary Care Physicians...Will you doctor be a 'real M.D, or are the bean counters changing basic medical education?  Can student doctors be mature and ready to make clinical decisions, or will more and more education and training be transferred to residency training?

Increased need for Primary Care Physicians---

Details of UC-Davis Pilot Program

An accelerated medical school program already is being tested at the UC-Davis School of Medicine in conjunction with Kaiser Permanente. The first six participants began classes in June (California Healthline, 7/21).

The program -- called Accelerated Competency-based Education in Primary Care -- cuts out electives, summer vacations and the search for a residency slot. Studies already completed at various other Medical Schools have been published (see below)

Academic Medicine:

September 2007 - Volume 82 - Issue 9 - pp 895-899

doi: 10.1097/ACM.0b013e31812f7704

Careers in Medicine

Tonya Fancher, director of the program, said the initiative aims to increase the number of primary care providers in California amid a growing shortage of such providers ("Shots," NPR, 8/7).

Manpower and Human Resource Planning in the 21st Century

The Affordable Care Act has catalyzed many drastic changes in medical education to improve accessibility, not just affordability for patient care.  These changes will further increase expenses without concurrent financing. Who will bear the burden ?

Calif. Doctor Shortage Could Lead to Higher Rates on Exchange Plans

AMA funds new Three years medical school at UC Davis  

Brown Signs Accelerated Degree Bill To Address Doctor Shortage  

Calif. Physician Workforce Increases, but Regional Disparities Exist

Technology and  Hospitals of the 21st Century.....They're here now

Palomar Medical Center is California's poster child for hospital innovation. Planning and implementing from scratch created a fertile system for inserting new technology as well as hospital design to improve efficiency, decrease cost and improve safety.  Even in the short term while the facility was constructed some features became obsolete even before the hospital opened. The advances in remote monitoring, biosensors gave new meaning to constructing facilities to incorporate more innovations in future years.  At some point one wonders how to anticipate as yet unknown breakthroughs with unknown possibilities.

Palomar Medical Center Photo Tour click here for further photos.

Google Glass                                                                          Electronic Health Record

                                                            Cyborg Rounds
 Patient Registration Lobby                                                       Remote Biometric Sensors

IOM Graduate Medical Education Report: Better Aligning GME Funding With Health Workforce Needs

Our prior blog posting, Medical Education Financing---Another iminent Fiasco  indicated that studies have been undertaken for revising Graduate Medical Education (GME) funding, by the Institute of Medicine (IOM) and others. The IOM is a highly respected and very influential group of leaders in medicine, headed by prominent scientists and physicians, such as Ben Carson M.D.

The IOM is part of theNational Academy of Sciences (NAS)

• National Academy of Engineering (NAE)
• National Research Council (NRC)

After nearly two years of deliberation, the Institute of Medicine (IOM) Committee on the Governance and Financing of Graduate Medical Education (GME) has issued its report. It presents a strong case for the need for change and a strong case for its recommendations.

Issues related to GME financing have been contentious for many years. In 1965, Congress included GME financing under Medicare reimbursement in what was intended to be a temporary arrangement. Nearly 50 years later, we are still trying to find a permanent and more rational way to finance and pay for the training of physicians as an alternative to the current complex, arcane formula built on Medicare inpatient days. Despite the well-documented shortcomings of the current system and numerous studies, attempts to find agreement on how to change and improve GME financing have been unsuccessful. 

Since the creation of the Medicare and Medicaid programs in 1965, the public has provided tens of billions of dollars to fund graduate medical education (GME), the period of residency and fellowship that is provided to physicians after they receive a medical degree. Although the scale of govern­ment support for physician training far exceeds that for any other profession, there is a striking absence of transparency and accountability in the GME financing system for producing the types of physicians that the nation needs.

Graduate Medical Education That Meets the Nation’s Health Needs