Healthcare IT

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Information technology has the possibility of greatly increasing the efficiency of health care.  EMRs can reduce the cost of accessing patient information.  New technologies can make medical devices more effective.  

But is there a cost to increased medical technology?  GigaOM wonders

“...will widespread diagnostics increase the burden on healthcare? Somewhere between 10 and 50 percent of autopsies reveal diseases other than the one that killed the patient. If consumers test themselves, then tell their doctors, the medical system could wind up treating 50 percent more diseases than it does today — even those that wouldn’t have killed the patient.

Will treating diseases before they appear increase health care quality or just drive up costs?  On the future will reveal the answer.

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MedPedia is a new project similar to Wikipedia but for medicine. It will act as an online collaborative medical encyclopedia available to the general public. Unlike Wikipedia, content editors and creators are required to have an MD or a PhD. Organizations funding MedPedia include some well-known acronyms: CDC, NIH, and FDA.

One question remains: will MedPedia be a significant improvement over existing sites such as WebMD and MayoClinic? We will see when the site goes live at the end of 2008.

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As I noted in an earlier post, choosing a Medicare part D plan is difficult.  However, there are resources to help people choose a Medicare Part D plan based on which prescriptions they are taking and where they live.  Medicare has its own Personalized Plan Search.  The private sector also has come up with user-friendly ways to search for the best health care plans.  MedicareSaver has an easy-to-use plan selector which also includes a video guiding you along the site.

With Health 2.0 gaining strength, choosing a health insurance is not as difficult as it once was.

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Children’s Hospital Boston and Harvard Medical School has launched HealthMap, an automated data-gathering system used to track disease. HealthMap aims to organize and disseminate this online information using feeds from various public health organizations.

This is similar to the concept I first saw at the Who Is Sick website, but the HealthMap seems to be a step forward. One the one hand, Who Is Sick site has user-generated data which may be more cutting edge, but Health Map has more data and data from more reliable sources. Further, HealthMap has the backing of prestigious organizations. I would not be surprised if HealthMap incorportated a user generated “Who is sick?”-like feature into their website.

Public Health thrives on the exchange of information, and new IT developments are certainly improving the quality of public health around the world.

Today, Google has made its Google Health program publicly available. You can get a tour of Google Health here and FAQs are available here.

TechCrunch has a great comparison (“…Hands-on Look“) of Google Health and Microsoft’s HealthVault.

“Whereas HealthVault’s strengths seem to lie in tying together different health information silos on the back end, Google Health is focusing more initially on the consumer side. It is trying to do an end-run around the health establishment by trying to get consumers to manually load their own medical information into their profiles. HealthVault allows this as well, but seems to have stronger partnerships with back-end health data providers.”

Google promises never to advertise on Google Health. So how will they make money? Likely, there will be a Google search bar in the Google Health portal and Google can collect ad revenue from related Google.com searches.

TechCrunch wisely points out that:

“…the key is importing your medical record in there. That is going to be a huge hurdle in terms of people feeling comfortable giving that sort of data to Google in the first place, and then simply getting the data in an electronic form from their doctors.”

El periódico el País relata su opinión en el artículo “El Dr. Google te recuerda que tomes la pastilla” (en español).

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Rating websites are all the rage on the internet. From RateMyTeachers.com to RateMyCop.com, you can rate practically anything nowadays.

A new website called Vitals.com allows you now to rate your doctor as well. In addition to being able to read reviews from other patients, there are also other physician statistics. For instance, Vitals.com informs you whether or not the doctor is board certified, where the physician graduated from medical school, and also the rating of the medical school where they graduated.

For me, the more information available for patients, the better.

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According to Insurance and Technology, health insurer WellPoint has partnered with Zagat’s Survey to allow WellPoint’s members to rate their doctors.  Zagat’s will use its 30 point rating system to evaluate all doctors.  According to Spirit magazine, patients can grade doctors based on “including doctor availability, office environment, trustworthiness, and communication.”

Other websites, such as RateMDs.com, already offer patients the ability to rate doctors, but WellPoint is the first health insurer to offer this service to its members.

TechCrunch reports on a Facebook application that alerts potential donors to donate blood in times of shortage.  Take all Types (TAT) is the name of the innovative non-profit which invented this application.  The TAT website wisely states:

There are always shortages of blood throughout the nation, even though there are plenty of potential donors out there. After All, we all have blood we can share. The main issue is communication!

VentureBeat (“…Health 2.0…“) profiles six innovative Health 2.0 firms which were at the 2008 Health 2.0 Conference in San Diego.  Each firm on the list aims to reinvent the doctor patient relationship.

Included on the list is Carol.com which allows patients to do medical shopping.  PharmaSurveyor allows users to enter the medications they are on and see if there are any harmful drug interactions.

There are lots of innovative ideas coming down the Health 2.0 pipeline.

Electronic medical records (EMR) hold the promise of vastly improving the quality of medical care received in the U.S. today. One of the major issues with EMR is privacy however. Patients generally want their doctors to know as much about their health as possible in order to make the best possible medical diagnoses and treatment decisions.

Yet who should you trust with your EMR? Physician groups are generally too small to efficiently implement EMR. Further, if you switch doctors, most patients want their EMR to follow them. What if the health insurers are put in charge of the EMR? This may make the most sense, but some health insurers can use the EMR to learn more about the health of their enrollees. While this seems like a good thing, when a certain enrollee gets sicker, they may decide either to increase their premiums or to try to drop their coverage. A clear conflict of interest exists here.

What about a third party EMR vendor? Google and Microsoft both are offering EMR services. But do you really want one of these enormous corporations selling your most personal medical information to other companies?

One solution to this problem is Keyose.com. Created by Dr. Julio Bonis, Keyose is a completely anonymous EMR service. Here’s how it works:

  1. Users sign up and enter their personal health information.
  2. A username code is generated along with a public and private password. The public password is printed on an ID card that doctors can use to access medical information. The private password enables users to update their medical information. Further, Keyose allows patients to use their private password to enter confidential medical information that people with the public password (e.g.: physicians) will not be able to view. This allows patients to manage their own health care information.
  3. You do not enter personal data (e.g.: not your name or an e-mail) when you sign up in Keyose. Thus, you will not receive any marketing materials. Even if a hacker breaks into the system, they will not be able to match your medical information to your name or email.
  4. Finally, it is free to sign up.

As you know, there is nothing in life that is free. How does Keyose plan to fund this project? According to their “Help” section:

In the future we could include information about sponsors (including private health insurance companies, pharmaceutical or biomedical industries) mainly intended for doctors who access the personal health records. We could also charge for premium services (for instance translating the personal health record for international patients or providing contextual information about a patient’s diseases).

There are drawbacks to this patient-based EMR. Patients do not use the same jargon as physicians and, thus, much important information could be lost in translation between the physician and the patient. Also, the information is uploaded by the patient, and not physicians, nurses, or trained staff.

I tried out Keyose myself. It was pretty basic and could have used more pre-defined fields (currently there is only DOB, gender, blood type, allergies, and personal and family history). Specific fields detailing whether or not you have certain allergies, or whether you have received certain vaccines would be helpful. Also, I could view the confidential information section even when I logged in using the public password.

Nevertheless, Keyose does seem like an step in the right direction.

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