Healthcare and Social Media: Impact, Issues and Governance


The radical global growth in information and communications technology has given rise to the number of internet users who account for 37% of the world’s total population according to ‘Internet World Statistics’.

With this growth, burgeoning use of social media has also increased which includes collaborative projects such as Wikipedia, blogs and content communities such as Twitter and YouTube, and social networking sites such as Facebook and LinkedIn.

The world has seen the influence of social media on global political and community initiatives which has lead to its widespread recognition and use.

Social media has also influenced the healthcare industry and has widespread implications for its stakeholders. The World Health Organization has pages on social networking websites which share information regarding disease patterns and potential epidemics to its global followers.

Impact

Like other industries, social media has had an astounding impact on healthcare. Consumers can now express concerns or share information with healthcare professionals or other consumers through social networking websites. Through social networks, blogs, forums and communities, healthcare providers and consumers can communicate their issues and get immediate responses. According to research, 30% of adults in the U.S have been found to have received help through information found on the internet.

Indeed, social media has spread like wildfire and its outreach has influenced even the busiest individuals such as healthcare professionals. Providers and nurses have the opportunity to stay up-to-date with recent developments in the healthcare industry. Care providers professionals can now interact with others in the industry and share ideas and experiences.

Use of Social Media in healthcare has updated the way patients and care providers can connect. Ramona Nelson, co-author of a book explaining the impact of social media on healthcare states, “Patients are becoming our colleagues. It’s changing relationships and the kinds of questions and services a patient asks for.”

Issues

Increased use of social media has provided a new platform where the healthcare community can interact and interconnect, but it has brought with it several risks as well.

Healthcare providers are worried about the credibility of content being shared and used on social media . Since information is shared at such a rapid pace, moderation of healthcare related content is very important so that inaccurate information such as rumors about spreading diseases are dispelled as quickly as possible.

When people are sharing healthcare information on unmonitored social media websites, there is high risk of someone sharing private and confidential company information. This can be done deliberately or by mistake, nevertheless causing significant damage to providers, patients and the company. Such issues usually involve employees sharing confidential information about patients or the employer on social networks like Facebook or Twitter in the form of posts, comments or multimedia.

Other issues consist of disgruntled healthcare employees or patients trying to manipulate, bully and negatively criticize their employers or patients. Such occurrences not only pose risks to the individuals involved in unethical behavior which might lead to divorce with their employers, but also a threat to healthcare organizations who may find their reputation tarnished in the industry.

Governance

It must not be forgotten that healthcare professionals are responsible for the confidentiality of patient health information and company privacy laws, which is why the industry leaders in collaboration with regulatory bodies should develop, educate and implement stringent policies regarding healthcare information so that the risks posed by free and open information sharing platforms are minimized. The Royal College of General Practitioners in the United Kingdom recently developed the ‘Social Media Highway Code’ for its GPs to ensure that they meet their professional obligations and protect patient health information.

It is clear to see the vast benefits that the healthcare industry can utilize through responsible usage of social media. The most important thing now is for regulations such as HIPAA and HITECH to include and implement stringent rules governing the use of social media in order to protect all parties involved.

 

 

mHealth: The Way Forward


The rate of development in the mobile technology industry is unparalleled and it is now making headway in the field of health IT. The recent influx of medical professionals adopting the latest sophisticated tools to enhance care delivery and engage patients has meant that consumers now expect technology to simplify everything.

Healthcare providers are not the only ones looking to accept these technological advances, as their patients are demanding mobile applications to monitor their own health. Mobile health or commonly known as mHealth refers to the practice of medicine, public health surveillance and patient engagement through mobile devices such as tablets, phones etc. This can provide a means for care givers and patients to access clinical records from anywhere, patients able to request prescription refills or appointments and most importantly the ability for patients to monitor their health constantly and from anywhere in the world.

In a recent hearing launched by the Subcommittee on Communications and Technology, Jonathan Spalter, chairman of Mobile Future, an organization that represents innovators across the wireless community said, “Nowhere is that promise of future innovation and opportunity greater than mobile health. Our message today is that the innovation and vision exist now in both the medical and technology communities working together collaboratively. This progress will proceed, in many respects, as rapidly as government allows.”

The mobile health market is expected to reach around $26 billion by 2017. According to a recent report, there are close to 100,000 mobile health applications and more in development by well known health IT vendors. Not only are there a number of mobile phone applications for patients but there are many in the making for healthcare professionals.

The Manhattan Research Survey estimates that in 2012 there were approximately 75 million users of Mobile Health or mHealth, who not only searched for health related issues on their mobile phones through popular search engines, but also actively used mobile phone applications to monitor and improve their health. In the same report, it was stated that almost half of the older population (55 plus) were using mobile devices to search for health related issues.

Electronic Medical Records or EMRs were originally built to be run on devices which were platform specific. This has changed with the rapid development and commercial use of technological innovations. Web-based EMRs have now allowed doctors to be truly mobile and can run on any platform or device; whether it be a computer a standard office computer, a laptop, tablet or a Smartphone. Although the demand for mobile-health solutions is increasing, some in the healthcare community remain skeptical about the implementation of such solutions.

David Levy, MD, global healthcare leader, PwC says, “Despite demand and the obvious potential benefits of mHealth, rapid adoption is not yet occurring. The main barriers are not the technology but rather systemic to healthcare and inherent resistance to change. Though many people think mobile health will be ancillary or bolted on to the healthcare industry, we look at it differently: mHealth is the future of healthcare, deeply integrated into delivery that will be better, faster, less expensive and far more customer-focused.”

There are always obstacles for any potential technology to fully integrate with and possibly overtake current technological systems, but there is no denying that mHealth is the way forward for the healthcare industry. A recent study undertaken by PwC shows that a majority of consumers predict that in the next three years, mHealth will vastly improve the quality, cost and convenience of the entire care delivery process.

 

Medical Device Interoperability


Medical devices are of paramount importance to patient care and well being such as the equipment used for clinical measurement, for instance x-ray imaging, temperature, blood pressure and critical life support. Although we depend heavily on modern medical equipment to treat patients, the devices used in practice are usually not interoperable and cannot connect with other devices. This inadvertently causes accidents which may easily be prevented through an interoperable network of devices.

In a traditional intensive care unit, patients are given treatment with the help of numerous devices such as ventilators, electrocardiographs and vital sign monitors. Most of the time, the manufacturers are different for each of these devices, which makes it harder for these devices to be integrated accordingly.

According to a report by the World Health Organization, there are approximately 1.5 million various medical devices in more than 10,000 different types of device groups available globally. These devices are instrumental for effective prevention, diagnosis, treatment and rehabilitation of diseases, and can be used in different settings such as clinics, hospitals and homes by patients, individuals and healthcare workers. They can also be integrated to a cloud Electronic Medical Records network which can make it easier for healthcare providers to record and monitor the performance of these devices.

Peter Pronovost, MD, Medical Director for the Center for Innovation in Quality Patient Care at John Hopkins University sheds some light on the reasons we need interconnected medical devices. “Medical devices need to share data, so that they can better inform clinicians and help patients,” said Mr. Pronovost. “By doing so, we can both improve quality and reduce costs.”

Similarly, a report by Deloitte states that 61% consumers are interested in using a medical device for checking their condition and electronically share that information with their healthcare providers through the use of technologies such as the EMR or Patient Portal.

medical devices

Through the use of medical devices integrated with Electronic Medical Records, precious lives can be saved. For example, surgery procedures require surgical instruments and radiotherapy units are required to treat cancer patients. In the example of a cancer patient, an infusion pump giving pain medication to the patient can share and exchange data with the vital signs monitor to ensure that the patient is not being given a higher dose.

Joseph M. Smith, MD, Chief Medical and Science Officer of San Diego-based WHI said, “We see an enormous opportunity to use information technology and device innovation to bring about the much needed transformation in healthcare delivery.” He further added, “Today’s hospitals are filled with medical devices that are unable to share critical data, creating potential dangers to patients, as well as inefficiencies that put a tremendous financial burden on our healthcare system.”

 

The iBlueButton experience – Part II


In terms of usability and simplicity, the iBlueButton is a far cry from its crude predecessors. The information gathered from the conventional Blue Button application is cumbersome to process and often confusing. Therefore, this limited the effectiveness of Blue Button and subsequently proved as a hindrance towards the adoption of this new feature in health IT. Complicated numbers and digits instead of simplistic information put a cap on the true potential on the idea behind the inception of Blue Button. However, through the iBlueButton app the feature is easy to both access and to employ for all. Using the iBlueButton on a mobile device is a totally different experience than that of the traditional Blue Button.

With respect to the resourcefulness of the mobile app Dr Mostashari added, “When I saw my Dad’s information it changed everything. Because for the first time, you hit the provider button, it brings back a list of all his doctors, and their phone numbers and their addresses. I never had that before. Now I can see his medications, diagnoses, ER visits, outpatient visits, procedures, images and labs.”

According to Bettina Expert on, CEO of Humetrix, the iBlueButton is not merely a physician or physician app. It is a mobile communications instrument which links one side of the healthcare equation with the other. Moreover, the iBlueButton grants real-time access to various healthcare resources such as a patient’s essential medical information. With an air of authority Expert on proclaims, “iBlueButton is the mobile embodiment of Blue Button”.  Expert on who is a professor of medicine at the University of California and is invited regularly to the counseling panel on healthcare in the White House also assisted in manufacturing the EHR smart card for the French national health system. As the Apple based application gains traction with the public, Expert on has unveiled that an Android based version of the iBlueButton will be available later this month as well. Additionally, several commercial health plans are going on board with employing Blue Button. This bodes well for Humetrix and the healthcare industry alike.

The amount of information accessible to patients while they are on the go will undoubtedly transform conventional healthcare practices. Instead of calling up various entities, scheduling appointments and waiting in line, one may simply view everything they require on a screen in their pocket while sitting in the comfort of their homes. This rapid access to health information will prove detrimental, especially in emergency situations where every second could be the difference between life and death.  Having the ability to obtain and share medical records at any point of care is the main differentiation from traditional EMRs. The level of convenience to the patients themselves enables them to be more informed and proactive towards personal care as well. Innovation in health IT is finally catching up with our daily lives and providing avenues for continuous improvement in care delivery. Such advances in technology will without question shape the future of healthcare as we know it.

 

The iBlueButton experience – Part I


During the course of the past few weeks, there has been some commotion and excitement in the healthcare community over the successful introduction of the mobile Blue Button. Many individuals within the industry are familiar with the concept of the Blue Button, however, since half of the clinician populace across the nation has not opted for EHRs, a large percentage of physicians are still oblivious to this common health IT terminology. Essentially, Blue Button is a tool which allows users of electronic medical records to obtain their personal health information via downloading it in various formats on their computers. It was initially designed as a platform to allow American Veterans easy access to their personal health information.

Blue Button has already been used extensively by hospitals throughout the country. Numerous federal agencies such as HHS (Health and Human Services), DOD (Department of Defense) and VA (Veterans Affairs) have applied Blue Button to facilitate their beneficiaries. The most basic format in which Blue Button allows the user to download their personal health information is a text file. By default the file downloaded from this technology is ASCII which is machine readable, meaning that the file may be downloaded in a variety of formats as required, such as text, PDF etc. As mentioned earlier, a Blue Button ASCII file is machine readable, which essentially means it can be parsed (broken down and analyzed) with a straightforward program on any basic computer. The downloaded text file may be accessed on any mobile device or computer without the need for any specific program. These files provide an effortless medium for transmitting health information amongst an assortment of members within the healthcare continuum.

Now, there is a new development in the world of health IT with regards to Blue Button, which is the iBlueButton mobile application. Humetrix is the health IT vendor which is responsible for shaking up the entire industry by introducing this revolutionary technology. Humetrix, a California based organization, revealed its iBlueButton 3.6 physician and consumer apps last October and won the national Blue Button ‘Mash Up’ Challenge. According to Todd Stein, the official spokesperson for Humetrix, thus far no one has been successful in making an application which makes a patient’s complete medical record accessible on their mobile device directly from their provider being solely under the patient’s control. As a result of this remarkable modernization, millions of military veterans and 37 million Medicare patients may now download their Blue Button medical record via their iPad or iPhone.

During a summit convened by the Bipartisan Policy Center in Washington DC, the National Coordinator for Health Information Technology (ONC) Dr. Farzad Mostashari was full of praise for the iBlueButton and its implication within the healthcare community. To quote, Dr Mostashari while sharing a personal story exclaimed that the iBlueButton “opened my eyes”. During a medical emergency pertaining to his father, Dr. Mostashari downloaded his father’s full medical record using the iBlueButton application. Upon obtaining the record, Dr. Mostashari shared it electronically with his father’s doctor who was astonished to see it, as this was unprecedented for him. Pleased with the resourcefulness of this app, Dr. Mostashari comments, “This is patient engagement at its best. This is the future of healthcare. I’m a doctor myself and when I first saw this, it was a real eye opener. I had first tried to download my father’s file from CMS’s Blue Button but it was everything I kind of feared – long, not pretty, it’s got all these codes that you don’t understand, the name of the provider is a number.”

Read more: Are EHRs more reliable than conventional paper-based systems?

 

EMR adoption and Meaningful Use


As the rate of EMR adoption grows across the country, physicians are beginning to express doubt regarding their ability in meeting the latest interoperability benchmarks.  According to a study, approximately fifty percent of hospital administrators across the U.S felt that their hospitals were ready to meet the set forth in Meaningful Use stage 1 requirements. However, the remaining fifty percent were uncertain about the readiness of their organizations to comply with the latest CMS guidelines.

While the American Recovery and Reinvestment Act (ARRA) was a clear attempt to lure practices into early adoption of an EMR system, it also initially created new revenue opportunities for IT vendors. These vendors now face a greater challenge because the second stage of Meaningful Use will require providers to actually perform the tasks that they merely needed the capability for in Stage 1. Most vendors assured their clients of their system’s compliance with stage 1, but stage 2 requires much more from these systems than many providers anticipated. Hence, industry experts suggest that doctors should start their stage 2 preparations right away, as they will require help from their staff, patients, hospitals and most importantly their EMR vendors in order to comply with stage 2.

Providers should initiate their practice evaluation process by assessing what they already have and what they need to purchase or upgrade. On one hand, it is encouraging to see the number of practices endorsing electronic documentation rising consistently. However on the other hand, a rush to adopt electronic medical records has led to unwarranted side effects, namely lack of training and poor quality of implementation. The eventual result of such incomplete implementation is that providers are unable to achieve the level of productivity and efficiency which can be expected from the usage of EMR technology, while this can also have a negative impact on the quality of patient care.

Meaningful Use stage 1 is currently under way, while stage 2 starts in January, 2014. Physicians will be required to adopt EHR technology and comply with the meaningful use criteria by October, 2014 or the payments they receive from Medicare will be reduced in 2015. Patient Portals are a major part of the stage 2 requirements and physicians will have to determine whether their current system has the functionality for patients like secure messaging, access to health information, lab results, ability to request prescription refills etc. Stage 2 will also be focusing on the exchange of health information to enhance care coordination along with information security and privacy. Providers will need to determine which regional; state or private health information exchanges will be involved in clinical data sharing.

Providers may have received incentives for stage 1 Meaningful Use compliance, but later stages will require greater commitment than initially anticipated by many. As a conclusion, it is evident that now is the time for action and providers must immediately direct their efforts towards the acquisition, implementation and utilization of an EMR solution, one that will consistently comply with any updates in the Meaningful Use requirements over the next few years.

Read more: 9 Steps to Successful EHR Implementation

 

EMR Implementation – The Expert Advice (Part 1)


With the government’s initiative to take healthcare into the new era of technology, practices of all sizes are vying to make the transition from paper to electronic documentation. For any practice seeking to make this conversion, a thorough analysis of their operations is required in order to assess how the implementation of an EMR solution should begin. Various operational aspects of the physician’s office have to be factored in prior to the beginning of the EMR implementation phase. Ray Parker, an EMR implementation specialist at a major health IT organization, gives us his take on the subject matter explaining the approach that practitioners should take in order to ensure a smooth execution of the system within their offices.

First and foremost, general practitioners and specialists alike have to identify the specific needs of their practices, while fully comprehending the reasons for conversion from paper to electronic medical records or a switch to a different EMR vendor. They have to ask whether they are looking to expedite documentation and reporting, and whether their existing solution inadequately equipped to handle these needs. Regardless of the motives driving physicians towards adoption, their eventual goal may well be common i.e. complying with Meaningful Use measures. If they are conforming to the standards set by CMS, the practice efficiency and expedition of operational processes is expected to improve by leaps and bounds. A significant determinant while finalizing your selection of the vendor should be the qualifications of the vendor organization (with special emphasis on the quality certifications) and subsequently judging the capability of the vendor in terms of meeting your practice requisites.

During the process of ascertaining the clinical and administrative requirements of the practice, some fundamental questions need to be answered and communicated with your vendor. For instance, how many clinicians are based within the practice, the workflows they follow, how many staff members need access to the system and what will be the corresponding training requirements etc? The practice has to be prepared beforehand to convey the entirety of its needs to their chosen service provider preceding a demo of the vendor system. For example a practice might want to stop getting paper faxes and want to receive their faxes electronically instead, or a practice may want to opt for an electronic lab interface with a local lab company. To help the vendor understand specific practice requirements, it’s very helpful to ensure that providers share their existing clinical data templates and specialty specific workflows before scheduling a demo with the vendor.

With respect to implementation, it’s of utmost significance that communication between physicians and vendors is crystal clear regarding data preservation requirements of the practice. Keeping into mind the legal ramifications of maintaining historical data (which varies from state to state), a provider has to aptly determine how much data has to kept and migrated. The vendor must be able to meet these necessities or propose appropriate alternatives to avoid unwarranted outcomes. Size and nature of their data plays a huge role at this stage, as clinical and billing data from older/outdated EMRs is very tedious to extract and even more complex to migrate. Apart from the data requisites of the practice, the clinician should also communicate any specific hardware requirements with their vendor. This provides an opportunity to the vendor to deal with any hardware compatibility problems that may arise at a later stage.