SMARTMD Monthly Newsletter- A Timely Summary of Your IT News

Survey Reports Medical Information via the Internet Increasing

An interesting survey came out recently by the Deloitte Center for Health Solutions that talks about the consumers use of the internet. The report states that 55% of consumers report using the internet to find treatment information. And according to the survey, 53% of seniors, 55% of baby boomers, 57% of Generation X and 56% of Generation Y look up treatment information online. 

It found that 1 in 4 respondents reported searching online for physician care quality information and that 12% looked up provider cost information online. About 10% of respondents reported using the internet to compare hospital treatment options. The report had a total of 4,008 U.S. adults surveyed between December 28, 2009 to January 5, 2010.

There is now a wealth of various consumer and physician medical websites that do everything like matching a patient's symptoms to a variety of diagnoses. And then there are those sites that even tell you the types of medications that are prescribed for any condition, including their dosage and how they are to be taken; I.V., oral, injection, etc. 

Is there too much information available to the consumer? If you have a smartphone, there are even more medical sites available via purchasing "apps" . Some are free and some are for a fee. Either way, self-diagnosis seems to be a given.

Study Finds At-Home Monitoring Lowers High Blood pressure

Kaiser Permanente Colorado 's Institute for Health Research just released a study showing the use of at-home blood pressure monitors and Web-based reporting tools that connect patients and clinicians appears to significantly improve patients' ability to manage their hypertension down to healthy levels, according to new research. The study, which was led by Kaiser Permanente Colorado in collaboration with the American Heart Association and Microsoft, followed 348 patients, ages 18 to 85, with uncontrolled high blood pressure. The initial study data was presented today by Kaiser Permanente Colorado researchers at the American Heart Association's 11th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

According to the Kaiser Permanente researchers, participants in the study were randomly assigned to a usual care group or a home monitoring group. All patients had their blood pressure measured in the medical office at the start of the six-month study. The usual care group was managed in a typical model that involved checking blood pressure during office visits.

The home monitoring group used an at-home blood pressure device that uploaded data to the patient's account in Microsoft Health Vault, a security enhanced, Web-based data storage platform. At the time of entering the study, those participants opted into a Kaiser Permanente application that automatically transferred the home blood pressure readings to Kaiser Permanente's electronic disease registry. Kaiser Permanente's clinical pharmacists then used the computerized registry to monitor readings and consulted with patients to adjust their antihypertensive medications based on proven protocols. Connected to Health Vault, patients were able to manage their data using Heart360, a free online tool provided by the American Heart Association.

At the start of the study, the average systolic blood pressure was 149 mm Hg in the home monitoring group and 145 mm Hg in the usual care group. At six months, patients in the home monitoring group were 50 percent more likely to have their blood pressure controlled to healthy levels compared to the usual care group. Similarly, a significantly greater decrease in systolic blood pressure at six months occurred in the home monitoring group (-21 mm Hg) versus the usual care group (-9 mm Hg).
 
Health experts have long known that the current approach to managing hypertension has shortcomings. Patients often don't comply with in-person visits, and when they do the measurements can be inconsistent or inaccurate.

While the in-person doctor-patient relationship will always be a cornerstone of care, one day the use of coordinated, secure health information technologies based at home or work could complement visits in a medical office, noted co-author Kari Olson, PharmD, a clinical pharmacy specialist at Kaiser Permanente Colorado .

Engaging patients with tools that make health management more accessible is a critical step in addressing the alarming growth of chronic diseases and associated increase in costs, said Peter Neupert, corporate vice president of the Health Solutions Group at Microsoft. The preliminary results of this clinical trial are significant and demonstrate how cost-effective and flexible technology solutions can encourage patients to be active partners in their health and help decrease their risk for life-threatening, acute care incidents.

Increased Demand for IT Consultants

According to a report from KLAS, the demand for skilled consultants is high. The report entitled Shifting Demand for Consultants: Who's Hot, Who's Not, and Why, is based on interviews with 118 healthcare providers and finds that nearly 70 percent of those interviewed expect to hire a professional services firm to help with the demands of achieving meaningful use.

Mike Smith, GM of financial and services research for KLAS states that healthcare IT professional services landscape has changed dramatically in the last three years and not only has the number of considered firms increased significantly, but the nature of services projects has changed as well. Since most large hospitals have already completed a major EMR implementation, more targeted engagements with smaller budgets - including advisory services and staff augmentation - are replacing the big budget, large-scale implementations.

For further information regarding KLAS, please go to their link http://www.klasresearch.com/

Technology chief Chopra calls for innovation

On May 18, 2010 the American Telemedicine Association closed out its 3-day international convention with a keynote address delivered by Aneesh Chopra, President Barack Obama's federal Chief Technology Officer, who urged the attendees to embrace innovation especially in healthcare.

Washington does not have a monopoly on great ideas, he said. In a 45 - minute speech delivered to a packed audience at the Henry B. Gonzalez Convention Center in San Antonio, Texas, Chopra talked of several newly launched federal efforts that reward entrepreneurship, collaboration and transparency, with a focus on rapid results. He said the White House has made it a priority to improve healthcare through the use of IT tools like cloud computing and mobile communications.

Chopra also announced that the Centers for Medicare and Medicaid Services is actively working to address the Joint Commission Standards for Credentialing and Privileging - in particular, the issue of credentialing healthcare workers involved in TeleHealth projects that stretch across state borders, an ongoing issue that has, in the past, been hotly debated between CMS and ATA officials.

In addition, Chopra called attention to the Department of Agricultures new Power of Telemedicine Web discussion. Organized by Jonathan Adelstein, administrator of the USDA ' s Rural Utilities Service, the blog is designed to collect public comments on telemedicine and TeleHealth.

Chopra's speech and subsequent tour of the show floor concluded what ATA officials are calling the most successful of their 15 conferences so far. According to outgoing ATA President Karen Rheuban, the conference attracted thousands and a 25 percent increase over last years total, and doubled the size of its show floor.

Report from Computer Giant Intel Reveals the Future of Healthcare to be Reliant on TeleHealth Technology

A new report from Intel shows that healthcare is likely to become increasingly reliant on TeleHealth (TH) in the next ten years. TH includes long distance consultations, monitoring, and information sharing - everything from a doctor calling a colleague to discuss a case to state of the art surgical robots that can be remotely operated. Presented at the American Telemedicine Association's annual conference in San Antonio this month, Intel's report surveyed 75 top decision makers in the health industry about the future of TeleHealth. 89% believe that it will be a big factor in the next decade. Two-thirds already use TeleHealth in their facilities, and of the remaining third, half will implement TH programs in the next year. Information technologies and medicine are already in bed with one another, and we've seen plenty of evidence that this relationship is only going to grow stronger.

According to Data Monitor the US and Europe spent $3 billion on TeleHealth in 2009, and are projected to spend $7.7 billion in 2012. That's a lot of cash. There's also the corporate angle: GE is spending millions on their Healthy Imagination initiative which is full of TeleHealth projects including portable ultrasound monitors , and online health education. It's pretty clear that med-tech companies and healthcare providers are both ready to make medicine remote and mobile, but will you want the same thing? You probably should. With TeleHealth you have access to not just your doctor, but an entire network of medical professionals and medical research. At first, patients are unlikely to have to worry about how that network is harnessed. Doctors will use advanced software (based on the collective knowledge of the medical community) to advise their decisions, your medical data (properly encrypted and secure -we hope!) will be passed on to experts in the field, and operating rooms will contain remotely controlled surgical robots . All these TeleHealth applications will provide you with better care and help speed your recovery, but they will essentially be out of your hands.

Eventually though, TeleHealth will also be a path for patient empowerment. At its heart, TH is about information, where it goes, who sees it, and how it can be leveraged to provide better care. With access to this data stream, patients will be able to do their own research, and help advise their own treatments. You'll be able to perform your own health monitoring , consult online communities of patients who share your health conditions , and get your own personal DNA testing . Armed with this information you will be able to work with your doctor to guide your own proactive/preventative healthcare. TeleHealth has global implications as well. Mobile phones equipped with microscopes could give remote communities access to high quality laboratory testing. Disaster relief could be aided by smart phone apps . Enormous databases for diseases will be accessible to doctors all over the world.

The next decade is going to be an exciting time in healthcare, not just because of the many miraculous treatments and cures we've seen in development, but because we're going to approach medicine from a much more tech savvy vantage point. Information technology is accelerating, powered by advances in processing power and the growing interconnectivity of people and computers. When applied to medicine, IT has the potential to revolutionize healthcare, moving us away from a single patient-doctor relationship to a web of peer-patient-doctor-expert-database interactions. We'll still keep the trusted doctor-patient bond, but each side of that relationship will act as a gatekeeper to much deeper stores of data. That data is going to help you stay healthier. As Intel reports, medical providers see the TeleHealth revolution as bringing about lower costs and much improved patients outcomes. No doubt about it, medical knowledge is power... yours is coming.

On the Technology Front: Recovery.gov Moved to Cloud Infrastructure Managed by Amazon

The federal government has moved Recovery.gov - the website that allows U.S. residents to track spending of the 2009 federal economic stimulus package -- to Amazon's Elastic Computer Cloud infrastructure-as-a-service platform, InformationWeek reports ( Hoover , Information Week , 5/13). The stimulus package includes billions of dollars in funding aimed at promoting health IT adoption.

In cloud computing, an agency or company pays a third-party host for access to online hardware and software applications each time they are used. According to NextGov , White House officials are encouraging government agencies to transition their IT systems to the cloud format within 10 years to:

1. Consolidate data centers;

2. Reduce greenhouse gas emissions

3. Increase efficiency by providing employees with remote access to the federal IT infrastructure

The Recovery Accountability and Transparency Board said the transfer will produce savings of about $750,000 over a two-and-a-half year period and "significantly more savings" in the long term.

Moving to a cloud computing infrastructure also will enhance security by allowing greater protection against network attacks and real-time detection of system tampering, according to the board.