"patient-centered medicine" entries

Patients matter most, but technology matters a lot

Report from the Health Data Forum

Computing practices that used to be religated to experimental outposts are now taking up residence at the center of the health care field. From natural language processing to machine learning to predictive modeling, you see people promising at the health data forum (Health Datapalooza IV) to do it in production environments.

Read more…

Saint James Infirmary: checking the pulse of health IT at HIMSS

Signs of the field's potential along with self-imposed limits

I spent most of the past week on my annual assessment of the progress that the field of health information technology is making toward culling the benefits offered by computers and Internet connectivity: instant access to data anywhere; a leveling of access for different patient populations and for health care providers big and small; the use of analytics to direct resources and attack problems better.

The big HIMSS conference in New Orleans, a crossroads for doctors, technologists, and policy-makers, provided a one-stop check-in. I already covered several aspects of the conference in two earlier postings, Singin’ the Blues: visions deferred at HIMSS health IT conference and Slow & Steady: looking toward a better health IT future at HIMSS. Here I’ll summarize a couple more trends in data exchange and basic functions of health IT systems.

Read more…

Slow & Steady: looking toward a better health IT future at HIMSS

Participatory medicine and hospital technologies take steps forward

After my funereal disparagement yesterday of the opening of the HIMSS health care conference in New Orleans, I decided to pick up the beat today and talk about some of the people and ideas I encountered with promise for the future.

Nobody Knows The Way I Feel This Morning: patient engagement and all that jazz

Yesterday I spoke of the gap between the reform-minded leaders of health care and the institutions that mostly take care of us. The latest battleground between these peaks of care is the movement variously called patient engagement, patient empowerment, and participatory medicine.

There’s nothing new about this concept. Desperate patients have been self-educating, negotiating with health care systems, and creating advocacy groups forever. On the self-help front, Prevention Magazine began (according to Wikipedia) in 1950. The Society for Participatory Medicine was founded in the mid 2000’s, around the time e-Patient Dave made the concept into a meme through his brave online sharing of his care.

HIMSS has thrown its support behind the Society for Participatory Medicine, which had a lunchtime meeting at the conference yesterday to discuss increasing membership and grass-roots promotional activities. (Folks, consider yourselves promoted.) HIMSS also invited teh popular author Eric Topol to deliver yesterday’s keynote. And the first statement offered by Topol was praise for Regina Holliday, a consumately self-educated patient advocate and creator of the famous artwork and painted jackets in the Walking Gallery. Read more…

Singin’ the Blues: visions deferred at HIMSS health IT conference

The main concerns of health reformers don't rise to the top of health provider agendas

HIMSS, the leading health IT conference in the US, drew over 32,000 people to New Orleans this year (with another thousand or two expected to register by the end of the conference). High as this turn-out sounds, it represents a drop from last year, which exceeded 37,000.

Maybe HIMSS could do even better by adding a “Clueless” or “I don’t believe in health IT” track. Talking to the people who promote health IT issues to the doctors and their managers, I sense a gap–and to some extent, a spectrum of belief–in the recognition of the value of gathering and analyzing data about health care.

I do believe that American health care providers have evolved to accept computerization, if only in response to the HITECH act (passed with bipartisan Congressional support) and the law’s requirements for Meaningful Use of eleectronic records. Privately, many providers may still feel that electronic health records are a bad dream that will go away. This article presents a radically different view. I think electronic health records are a bad dream that will go on for many years to come. I’ll expand on this angle when blogging from HIMSS this year.

Read more…

How to open an industry: data points from Strata Rx

O'Reilly conference brings together health care and data

O’Reilly’s first conference devoted to health care, Strata Rx, wrapped up earlier this week. Despite competing with at least three other conferences being held on the same week around the country on various aspects of health care and technology, we drew a crowd that filled the ballroom during keynotes and spent the breaks networking more hungrily than they attacked the (healthy) food provided throughout.

Springing from O’Reilly’s Strata series about the use of data to change business and society, Strata Rx explored many other directions in health care, as a peek at the schedule will show. The keynotes were filmed and will soon appear online. The unique perspectives offered by expert speakers is evident, but what’s hard is making sense of the two days as a whole.

In this article I’ll try to show the underlying threads that tied together the many sessions about data analytics, electronic records, disruption in the health care industry, 21st-century genetics research, patient empowerment, and other themes. The essential message from the leading practitioners at Strata Rx is ultimately that no one in health care (doctors, administrators, researchers, regulators, patients) can practice their discipline in isolation any more. We are all going to have to work together.

We can’t wait for insights from others, expecting researchers to hand us ideal treatment plans or doctors to make oracular judgments. The systems are all interconnected now. And if we want healthy people, not to mention sustainable health care costs, we will have to play our roles in these systems with nuance and sophistication.

But I’ll get to this insight by steps. Let’s look at some major themes of Strata Rx. Read more…

Open source software as a model for health care

A doctor looks to software communities as inspiration for her own research

(The following article sprang from a collaboration between Andy Oram and Brigitte Piniewski to cover open source concepts in an upcoming book on health care. This book, titled “Wireless Health: Remaking of Medicine by Pervasive Technologies,” is edited by Professor Mehran Mehregany of Case Western Reserve University. and has an expected release date of February 2013. It is designed to provide the reader with the fundamental and practical knowledge necessary for an overall grasp of the field of wireless health. The approach is an integrated, multidisciplinary treatment of the subject by a team of leading topic experts. The selection here is part of a larger chapter by Brigitte Piniewski about personalized medicine and public health.)

Medical research and open source software have much to learn from each other. As software transforms the practice and delivery of medicine, the communities and development methods that have grown up around software–particularly free and open source software–also provide models that doctors and researchers can apply to their own work. Some of the principles that software communities can offer for spreading health throughout the population include these:

  • Like a living species, software evolves as code is updated and functionality is improved.

  • Software of low utility is dropped as users select better tools and drive forward functionality to meet new use cases.

  • Open source culture demonstrates how a transparent approach to sharing software practices enables problem areas to be identified and corrected accurately, cost-effectively, and at the pace of change.

Read more…

Five elements of reform that health providers would rather not hear about

Data as a platform, patient control, and partnerships are key

The quantum leap we need in patient care requires a complete overhaul of record-keeping and health IT. Leaders of the health care field know this and have been urging the changes on health care providers for years, but the providers are having trouble accepting the changes for several reasons.

What’s holding them back? Change certainly costs money, but the industry is already groaning its way through enormous paradigm shifts to meet current financial and regulatory climate, so the money might as well be directed to things that work. Training staff to handle patients differently is also difficult, but the staff on the floor of these institutions are experiencing burn-out and can be inspired by a new direction. The fundamental resistance seems to be expectations by health providers and their vendors about the control they need to conduct their business profitably.

Read more…

Five tough lessons I had to learn about health care

Realistic conclusions and opportunities in health care.

Despite the disappointments I've undergone in learning about health care, I expect the system to change for the better. Those who want a better system need to look at the areas where change is most likely to make a difference.

Report from HIMSS 12: wrap-up of the largest health IT conference

Recalcitrant instincts that depressed me and progressive suggestions that restored me. Details DICOM, Watson, and other interesting projects.

Report from HIMSS 2012: toward interoperability and openness

Two key pillars of the Stage 2 announcement are requirements to use the Direct for data exchange and HL7's consolidated CDA for the format.