The Future of Medicine

There are many 'futurists' forecasting what will develop in the next decade.

Early on in the 21st century we have witnessed the acceptance of electronic health records, health information exchanges, big data and analytics, the development of health care social media, #hcsm, digital communication, mobile health and hardware advances such as Smartwatch

Among these published and verbal futurists are Eric Topol M.D.  Bertalan Mesko,

Apple smartwatch unveiling

Not only  is the  Future of Medicine dealing with Health Reform and Health Information Technology Advances, perhaps the greatest changes will be in  human capital. Medical schools are revising curricula which has had the same format since 1910.

Health Information Exchange development slows

Opinion: Government Intervention Will Not Fix Interoperability Issues

In response to a recent article by Republican senators on HITECH Act spending, Brookings Institution fellow Niam Yaraghi writes that he agrees that the health care IT system is not performing well but argues that Congress should turn to private-sector innovators to enhance interoperability rather than government regulations and standards. Brookings Institution's "TechTank."

ONC may have set the standards, however private enterprise is balking at the task due to poor economic models and lack of real financial incentives, savings, or better outcomes.

In a blog post on the Brookings Institution's "TechTank," Niam Yaraghi, a fellow at the Brookings Institution's Center for Technology Innovation, responds to a Health Affairs blog post by five Republican senators that questioned the success of the HITECH Act.Yaraghi writes, "While I agree with the senators that the health care IT system is currently not performing well, I do not believe they have realistic expectations for [the Office of the National Coordinator for Health IT]." He adds, "HITECH was designed with a lack of insight into how the health care market functions, and thus billions of dollars were doomed to be wasted and have no tangible return from the very first day."

Yaraghi calls it "naïve" to attribute the "failure of exchanging medical information to interoperability issues," writing that the issues do not stem from a "lack of standards" but "rather the lack of long-term market-driven economic incentives." He writes, "The best way to solve the lack of technical interoperability is through self-regulated, industry driven certification alliances." Yaraghi cites the Wi-Fi Alliance as an example of a "worldwide network of companies" that has successfully advanced interoperability in their products "through certification of compliance with particular standards." He attributes the Wi-Fi Alliance's success to the economic benefits reaped by its members, adding, "Health IT vendors will not take the time and do the hard work of creating such an alliance if the government volunteers to do the job for them."

Yaraghi recommends redirecting the remaining $7 billion in HITECH funds "toward incenting innovation." He concludes that Congress should look to the private sector for proposals that "provide a technical solution for interoperability" and "design business strategies in which different members of the market willingly contribute to information exchange" (Yaraghi, "TechTank," Brookings Institution, 3/5).

Serious reservations remain.   Where Is HITECH’s $35 Billion Dollar Investment Going?

On April 16, 2013, we released “REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT,” outlining concerns with implementation of the Health Information Technology and Economic and Clinical Health (HITECH) Act. Specifically, we asked: What have the American people gotten for their $35 billion dollar investment?

Two years after releasing the white paper, and six years since enactment of the HITECH Act, the question remains. There is inconclusive evidence that the program has achieved its goals of increasing efficiency, reducing costs, and improving the quality of care.

We have been candid about the key reason for the lackluster performance of this stimulus program: the lack of progress toward interoperability. Countless electronic health record vendors, hospital leaders, physicians, researchers, and thought leaders have told us time and again that interoperability is necessary to achieve the promise of a more efficient health system for patients, providers, and taxpayers.

Instead, according to physician surveys, electronic health records (EHRs) are a leading cause of anxiety for physicians across the country. The EHR products are not meaningful to physicians, which is clear when you consider that half of all physicians will have their Medicare payments cut in 2015 for not adopting government benchmarks for EHRs.

The Nationwide-Interoperability-Roadmap was outlined along with HITECH ACT.  It had lofty goals but was and still is disjointed with marked differences in implementation across the country.

Instead, according to physician surveys, electronic health records (EHRs) are a leading cause of anxiety for physicians across the country. The EHR products are not meaningful to physicians, which is clear when you consider that half of all physicians will have their Medicare payments cut in 2015 for not adopting government benchmarks for EHRs.

Mental Health Professionals Debate Use of EHRs, Incentives

Most Health Care Organizations Planning IT Investments This Year

EHR Trade Group Forms Workgroup for Health Care Delivery Reform

Physician Rankings, Ratings and Reviews

Today the rapidity of electronic communications creates the good possibility that your online ratings may fluctuate like the online trading tickers of the stock exchanges.

Physicians who do not check their ratings on a number of web sites are sticking their heads in the sands. Regardless of how well you think your rank, an ill mannered employee could sabotage your reputation online by a unhappy unsatisfied or even a malicious patient.

No one can prevent all negative reviews, however reviews must be monitored by a member of your staff regularly.

The most visible provider ranking and rating sites are:

The researchers evaluated four rating sites that rank or grade hospitals across the country:

• Consumer Reports;
• Healthgrades;
• U.S. News & World Report; and
• The Leapfrog Group (Abelson, New York Times, 3/2).

There are now services that will regularly scan up to   different rating sites and report their findings on a daily basis whenever a new review is posted.

Which sites matter?    There are 75+ major websites where patients can see reviews for doctors. Even though a website may not have a popular brand name like "Yellow Pages," it still can impact your reputation if it shows up when patients Google your name.

Review Report Card^® helps you keep track of your reviews on 75+ websites in a single glance. We do over 1,000 unique searches for you online and alert you every day new reviews are discovered. In addition to monitoring your reviews, you will be notified if your address is correct on each of the 75+ sites.

Patient Review Templates will help you boost your positive reviews. We recommend that you customize the templates and send them to patients between 24 to 48 hours after their appointment. The templates contain directions and hyperlinks they can follow to endorse you on each site.

A Harvard Business Review analyzed the effects of reviews (restaurants), 

and while not directly related to healthcare it does 

give some estimate of the 

power of negative evaluations 

Comparing the cost of monitoring your reviews may 

pale in comparison to the damage to reputation or 

income if negative reviews are missed.

The Uses for Health Care Social Media #hcsm

Many physicians have expressed a disinterest in social media. We all agree it must not be used for patient interaction because of HIPAA which prohibits sharing of patient information.

However during the past three years physician interest and use of social media has markedly increased.

Symplur Signals details how Health Care Social Media impacts health care and your medical practice.

More than 40% of consumers say that information found via social media affects the way they deal with their health. 

18 to 24 year olds are more than 2x as likely than 45 to 54 year olds to use social media for health-related discussions. - 

90% of respondents from 18 to 24 years of age said they would trust medical information shared by others on their social media networks.  (this amounts to mouth-to-mouth verbal referrals. Millenials use Social Media as true social interaction among friends. This provides an avenue for patient referrals, and must not be ignored. 21st Century medicine is far different than even three or four years ago.

30% of adults are likely to share information about their health on social media sites with other patients, 47% with doctors, 43% with hospitals, 38% with a health insurance company and 32% with a drug company.  

31% of health care professionals use social media for professional networking. - 

For a complete listing of the uses for health care social media

24 Outstanding Statistics & Figures on

How Social Media has Impacted the 

Health Care Industry

These are some of the published journal articles that have employed 

Symplur data in their research.

• The impact of social media on a major international emergency medicine conference.
  Neill, A., Cronin, J. J., Brannigan, D., O’Sullivan, R., & Cadogan, M. (2013). The impact of social media on a major international emergency medicine conference. Emergency Medicine Journal, emermed-2012. Chicago
• Social media in radiology: early trends in Twitter microblogging at radiology’s largest international meeting.
  Hawkins, C. M., Duszak, R., & Rawson, J. V. (2014). Social Media in Radiology: Early Trends in Twitter Microblogging at Radiology’s Largest International Meeting. Journal of the American College of Radiology, 11(4), 387-390.
• International Urology Journal Club via Twitter: 12-Month Experience.
  Thangasamy, I. A., Leveridge, M., Davies, B. J., Finelli, A., Stork, B., & Woo, H. H. (2014). International Urology Journal Club via Twitter: 12-Month Experience. European urology.
• Use of social media in urology: data from the American Urological Association (AUA).
  Loeb, S., Bayne, C. E., Frey, C., Davies, B. J., Averch, T. D., Woo, H. H., … & Eggener, S. E. (2014). Use of social media in urology: data from the American Urological Association (AUA). BJU international, 113(6), 993-998. Chicago.
• Social media: A tool to spread information: A case study analysis of Twitter conversation at the Cardiac Society of Australia & New Zealand 61st Annual Scientific Meeting 2013.
  Ferguson, C., Inglis, S. C., Newton, P. J., Cripps, P. J., Macdonald, P. S., & Davidson, P. M. (2014). Social media: A tool to spread information: A case study analysis of Twitter conversation at the Cardiac Society of Australia & New Zealand 61st Annual Scientific Meeting 2013. Collegian.
• e-Patients in Twitter Hashtag Communities.
  Harmel M, Young K. e-Patients in twitter hashtag communities . J Participat Med. 2013 Jan 16; 5:e22
• Nurses and Twitter: The good, the bad, and the reluctant.
  Wilson, R., Ranse, J., Cashin, A., & McNamara, P. (2013). Nurses and Twitter: The good, the bad, and the reluctant. Collegian. Chicago.
• Twitter Use at a Family Medicine Conference: Analyzing #STFM13.
  Mishori, R., Levy, B., & Donvan, B. (2014). Search Family Medicine Share Links. Fam Med, 46(8), 608-14. Chicago.
• The Dramatic Increase in Social Media in Urology.
  Matta, R., Doiron, C., & Leveridge, M. J. (2014). The Dramatic Increase in Social Media in Urology: Trends in Twitter Use at the American Urological Association and Canadian Urological Association Annual Meetings in 2012 and 2013. The Journal of urology.
• The social media revolution is changing the conference experience: analytics and trends from eight international meetings.
  Wilkinson, S. E., Basto, M. Y., Perovic, G., Lawrentschuk, N., & Murphy, D. G. (2014). The social media revolution is changing the conference experience: analytics and trends from eight international meetings. BJU international.
• Social Media and Pediatric Hospital Medicine: How Our Discipline Benefits From a Virtual Community and Why It Matters for Our Future.
  Webber, E. C., Fu, P., & McKenna, M. P. (2014). Social Media and Pediatric Hospital Medicine: How Our Discipline Benefits From a Virtual Community and Why It Matters for Our Future. Hospital pediatrics, 4(1), 51-53.
• Social Media Responses to the Annals of Emergency Medicine Residents’ Perspective Article on Multiple Mini-Interviews.
  Joshi, N. K., Yarris, L. M., Doty, C. I., & Lin, M. (2014). Social Media Responses to the Annals of Emergency Medicine Residents’ Perspective Article on Multiple Mini-Interviews. Annals of emergency medicine, 64(3), 320-325.
• Global Emergency Medicine Journal Club: Social Media Responses to the January 2014 Online Emergency Medicine Journal Club on Subarachnoid Hemorrhage.
  Chan, T. M., Rosenberg, H., & Lin, M. (2014). Global Emergency Medicine Journal Club: Social Media Responses to the January 2014 Online Emergency Medicine Journal Club on Subarachnoid Hemorrhage. Annals of emergency medicine, 64(1), 88-94.
• Using social media for continuous professional development.
  Moorley, C., & Chinn, T. (2014). Using social media for continuous professional development. Journal of advanced nursing.
• Networking opportunities for learning disability nurses.
  Abdulla, S., Marsden, D., Wilson, S., & Parker, M. (2013). Networking opportunities for learning disability nurses: Samuel Abdulla and colleagues explain why social media offer professionals new opportunities for information sharing, discussion and peer support. Learning Disability Practice, 16(5), 30-32.
• Using Twitter for professional knowledge.
  Kraft, M. A. (2013). Using Twitter for professional knowledge. Journal of the European Association for Health Information and Libraries, 9(4), 10.
• A Study on the Influence of Semantics on the Analysis of Micro-blog Tags in the Medical Domain.
  Vicient, C., & Moreno, A. (2013). A Study on the Influence of Semantics on the Analysis of Micro-blog Tags in the Medical Domain. In Availability, Reliability, and Security in Information Systems and HCI (pp. 446-459). Springer Berlin Heidelberg.
• Twitter for Public Health: An Open-source Data Solution.
  Nghiema, S., Mehtab, P., & Taoc, L. Twitter for Public Health: An Open-source Data Solution. Chicago.
• The Use Of Social Media In Endourology: An Analysis Of The 2013 World Congress Of Endourology Meeting.
  Canvasser, N. E., Ramo, C., Morgan, T. M., Zheng, K., Hollenbeck, B. K., & Ghani, K. R. (2014). The Use Of Social Media In Endourology: An Analysis Of The 2013 World Congress Of Endourology Meeting. Journal of Endourology, (ja).
• Twitter hashtags for health: applying network and content analyses to understand the health knowledge sharing in a Twitter-based community of practice.
  Xu, W. W., Chiu, I. H., Chen, Y., & Mukherjee, T. (2014). Twitter hashtags for health: applying network and content analyses to understand the health knowledge sharing in a Twitter-based community of practice. Quality & Quantity, 1-20.
• The emerging use of Twitter by urological journals.
  Nason, G. J., O’Kelly, F., Kelly, M. E., Phelan, N., Manecksha, R. P., Lawrentschuk, N., & Murphy, D. G. (2014). The emerging use of Twitter by urological journals. BJU international.
• #Urology Is Trending in Social Media.
  Bayne, C. E., Murphy, D. G., & Loeb, S. (2014). # Urology Is Trending in Social Media. Reviews in Urology, 16(3), 152.
• Social Networks, Social Media, and Innovating Surgical Education
  Ravinder, S., Vohra, M. D., & Elizabeth, Q. (2014). Social Networks, Social Media, and Innovating Surgical Education.
• Review of Twitter for Infectious Diseases Clinicians: Useful or a Waste of Time?
  Goff, D. A., Kullar, R., & Newland, J. G. (2015). Review of Twitter for Infectious Diseases Clinicians: Useful or a Waste of Time?. Clinical Infectious Diseases, civ071.
• Social Media in the Emergency Medicine Residency Curriculum: Social Media Responses to the Residents’ Perspective Article
  Hayes, B. D., Kobner, S., Trueger, N. S., Yiu, S., & Lin, M. (2015). Social Media in the Emergency Medicine Residency Curriculum: Social Media Responses to the Residents’ Perspective Article. Annals of Emergency Medicine.

Data from Symplur