Tuesday, February 7, 2012

Six Imperatives in Cancer Care

Nice poster outline for the imperatives to delivering excellent cancer care from the Advisory Board company

THeir Top 6 list:
1) Ensure adherence to evidence based guidelines
Seems obvious but often forgotten - 13% of Colon cancer patients receive non evidence based care.

2) Reduce unnecessary IP and ED utilization
The medical home is key to ongoing efforts to reduce the need for these services but maintain the patient/provider engagement and interaction

3) Focus Service investments on Services that increase Quality
Staging of the disease both for treatment and the reduction in the stress to patients remains a big target for improvement

4) Enhance Patient-Provider Communication
Lack of ability for patients to absorb the complexity of the information and ease of accessing guidance and provider are ongoing problems - there is much resistance to e-mail but reality os that written communication holds much value and the bonus of being able to refer back to it easily

5) Engage patient and families in End of Life PLanning
 - this was covered in a recent piece on the WSJ: 
Its not about giving up

That doesn’t mean oncologists are being encouraged to give up on extending the lives of those patients
Rather, the guidelines recommend combining palliative care — open and honest communication about the progress of the disease and the patient’s wishes, medical appropriate goal-setting and careful attention to symptom management — with standard oncology care)
Often forgotten in the desperate attempts and desires to fight the disease and frightening outcomes

6) Leverage Networks to advance cost and Quality goals
THis boils down to care coordination and communication. Ease of sharing all the data across systems, providers and facilities. We have much work to do here. Imagine if banks had the same status of coordination as healthcare - we would have to have accounts in every bank that we deal with and all duplicate data (and fees). No accessing cash or credit from any terminal or merchant......


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Thursday, January 12, 2012

Top Killers

The CDC has released the top causes of death list. 14 of the top 15 have not changed much in years but Homicide finally got pushed out by pneumonitis.

1. Heart Disease

2. Cancer
3. Lower respiratory diseases; 
4. Stroke and related cerebrovascular diseases; 
5. Accidents (unintentional injuries); 
6. Alzheimer's disease; 
7. Diabetes; 
8. Kidney diseases; 
9. Influenza and pneumonia; 
10. Suicide; 
11. Septicemia; 
12. Chronic liver disease and cirrhosis; 
13. Hypertension and related renal disease; 
14. Parkinson's disease; and 
15. Pneumonitis due to solids and liquids.

The good news is that overall the death rates from these causes has dropped including for heart disease, cancer, stroke, and chronic lower respiratory disease and the oft quoted infant mortality rate also declined to an all time low of 6.14 (per 1000 births).
Life expectancy increased by 1 month to 78 years and 8 months

Not clear if the trends will continue or even improve over time...and it will be interesting to see i the healthcare changes have a positive impact on these measurements

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Friday, January 6, 2012

Hospital CEO Thinks It's Perfectly OK To Show Patient's Records To Newspaper

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Seems there is much more to this story than first meets the eye. THe HIPAA regulations unintended consequences include the price that healthcare providers pay to suffer claims such as this made with either “no comment” or “disagree and if they follow the letter of the law are unable to comment because of patient privacy regulations.

Is patient privacy....patient privacy…….no matter the consequences or are there times and ways to address issues without jeopardizing patient privacy and patient information.

THere is no easy answer but it does expose another instance where we create regulations with good intentions but end up with unfortunate and undesirable consequences

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Monday, December 5, 2011

Social media to educate clinicians

In an interesting response to a problem of getting the word out 

>>>>Despite these compelling findings, an audit of UK hospitals in 2011 showed that, of 412 trauma patients who were ill enough to need a blood transfusion and therefore be eligible for tranexamic acid treatment, only 12 (3%) received the drug. The implementation rate in low-income and middle-income countries could well be lower still. The CRASH-2 trial results were published in this journal, widely reported in the international media, and presented at many trauma and intensive care conferences. How else could researchers reach out to practising clinicians and make them aware of this life-saving treatment?
<<<<<

Despite the compelling evidence implementation and uptake is low so the team came up with a "viral" video to get the word out. 
>>>>>
An enterprising idea that the CRASH-2 team rolls out today involves an adaptation of the concept of viral marketing—ie, a compelling video that internet users pass on to their online contacts. Drawing on the elements that tend to increase sharing (humour, surprise, emotion), the collaborators made a stop-motion animation in which a clay trauma victim, blood squirting heartily from a gaping hole in his abdomen, happily avoids imminent exsanguination by means of a timely injection. The video ends with an invitation to view the CRASH-2 trial results<<<<<

Expect more activities like this in the future

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Tuesday, November 22, 2011

What is HealthIT - Part 1

Soem interesting video presentation on HealthIT and Informatics from the Discovery Channel

Part 1:

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Wednesday, November 16, 2011

Wisdom from the Dalai Lama

Get on Board the Social Media Train or Get Left Behind Like the Bank of America

Bank Of America Just Had The Ultimate Social Media Fail

Julia La Roche | Nov. 15, 2011, 10:54 AM | 61,418 | 49

This makes you wonder if Bank of America, which is currently axing 30,000 of its staff globally, already cut their social media team.

Or if they don't already have a social media team, they should really consider getting one after this social media fail. 

It's been just a week since Google Plus started allowing for companies to have pages on the social networking site and it looks like someone already beat Bank of America to the punch, according to Carl Franzen at Talking Points Memo.

BofA's Google Plus profile bashes the already embattled Charlotte, North Carolina-based bank. The page, which is no longer available, features unflattering pictures of former CEO Ken Lewis and mocking wall posts.

One wall post said, "Living under a tarp? I am too. My TARP is much bigger, however, and billions of dollars more expensive."

It's possible that the page could have been created by the bank initially and then later hacked. 

However, according to Chester Wisniewski at the IT security blog NakedSecurity, the page was likely created by a group that tricked Google into thinking they were Bank of America. 

We've included a screen shot below. [via TalkingPointsMemo]

BofA Google Plus

Image: TalkingPointsMemo

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The power of social media - few hospitals or healthcare facilities have any focus on this area (building a web site and running and e-mail server does not count).
The University of Maryland Medical Center (http://www.umm.edu/) springs to mind as one of the leaders in this area with an impressive outreach and connection. I'm not sure what or how they staff it but am willing obey its built into every area and not confined to one or two social media job functions.

For those hospitals considering Social Media - this presentation on slideshare is a good foundation on why this is important and what it can do for your facility and originates from the University of Maryland:

This is not just some passing fad. It is messy and this troubles many facilities and executives as it is hard to control and manage but that is just part of our future engagement with our staff, patents and colleagues around the country and indeed world.

This train has left the station - get on board or get left behind

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Friday, November 11, 2011

Dragon Express - Available now in the App Store

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Dragon express was released this week at an amazing introductory price of $49.99. Great news for people wanting to try out Dragon on their Mac and for anyone who wants to effectively speech enable their applications especially social media.

The App store has made the ease of purchase an installation a breeze and finding the app and installing is as simple as clicking the Dragon Express Logo 
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or this link (which will take you to the web page and open up your App Store).

Watch the application in action with Peter Mahoney - the Dragon Dictator

There has been good coverage  from GigOMArs TechnicaMacWorld and Cult-of-theMac to mention a few and has done well in the App store rankings reaching #8 (behind 7 apple applications and one other "Growl"). Not bad for the first day

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Let me know what you think and how you get on with the application

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Wednesday, November 9, 2011

Is Siri the New Personal Health Assistant and Coder?

Brian Dolan thinks so:

Based on our own in-house testing here at MobiHealthNews, Siri in its current form could be helpful to both patients and healthcare providers alike. After asking Siri a number of questions, we were surprised how she answered some and that she was able to answer others.

And even for coding in OCD-9
Heartfailure

For health and diet

Release a product and people will find new and unimagined ways to use it. We are only just starting to scratch the surface of the potential

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Tuesday, November 8, 2011

The One Chart You Need To See To Understand Mobile

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The "Blue Ocean" (non-smart phones ripe for putting smart phones in the hands of users) is "huge". There remains much opportunity in the mobile market place but the penetration is increasing for Apple and Android with Android on a tear with its open-source strategy.
Mobiel devices are the mainstay of communication tools for people and as these increase in penetration and function voice integration and in particular the addition of intelligent interaction will become increasingly important and necessary.
I imagine the speech recognition business opportunity chart would look very similar offering the potential for a ver exciting and dynamic upcoming year.
Once again - its so great to be in a cool business that's growing so dramatically.

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Improved systems for vehicle voice recognition coming

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Cars that understand what you say....coming to a car near you.
Part of the ongoing push and the new age of speech recognition is the ability to understand what the driver asks for with interpretive system that include natural language processing (NLP) and some element of Artificial Intelligence (AI) to offer drivers a more conversational and useful interaction with their voice. A safer interaction that will be easier and faster.

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Monday, November 7, 2011

Butterfly Effect of Healthcare Quality Measures

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In an interesting unanticipated effect the AHRQ has highlighted the potential for the government changes to encourage physicians
>>>
"... may "fire" noncompliant patients from their practices, push back against quality-improvement initiatives, and minimize patient empowerment efforts, CQ HealthBeat reports. Some physicians already are "firing" unvaccinated patients, noting that they pose a risk to others and reflect a lack of trust for physicians' medical advice.
Since there already appears to be some instances of this where patents are unvaccinated it may well extend to other groups and would certainly be classified as an unintended consequence.

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Tuesday, November 1, 2011

Mobile Voice Recognition is Going to Rock Your World | Apple's Siri on the iPhone 4S is leading the way | Business News Daily

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Voice is cool! Voice recognition and its most recent persona - the now well known Siri on the Apple 4S is a star and has really captured the imagination of the public..... something we have been working at for a number of years in the healthcare sector.
The key to the success is the natural language understanding that is baked in to the solution. We have seen the value of this with the Dragon Go Product in the Apple App store and the healthcare sector is getting medical intelligence built into their solutions in the form of Clinical Langauge Understanding (CLU) and the latest medical intelligence in the new product of Computer Assisted Physician Documentation (CAPD)
Instant information and interaction comes to healthcare documentation helping create high quality specific detailed clinical documentation first time.

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Speaking in Context: Medical Language Models and Mobile Dictation

Speech recognition is an increasingly common interface - we interact with speech systems on the phone, using our phones and in our cars. But as Jonathan Dreyer points out in this piece - speech for general use is different to use in healthcare. In Healthcare it requires an appropriate context to attain the necessary levels of accuracy.
>>>What’s “humerus” to a clinician, and what’s “humorous” to a consumer are two very different things

Quite! So using the right versions tuned for the user and his domain - and int eh case of healthcare there are many different domains that can be applied for different specialties (Radiology, orthopedics, general surgery, general medicine...to mention just a few). With the right context and model applied medical speech recognition has become an integral part of clinical solutions and is becoming increasingly important in mobile applications where the keyboard interface is not always ideal or as easily accessible.

So while general speech recognition solutions are delivering real value to derive the same results in healthcare it is important not to fall into the trap of offering generic solutions that will work but generate too many errors to make them useable and worse will turn clinicians off the tools before they have even had a chance to experience the results that are possible today with the right tools for medical speech recognition

So if you are looking to integrate speech into your healthcare applications - use the right version that includes the relevant context and vocabulary models to at the outset and help create a positive experience for users from the beginning.

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