Ehealthnews

Health 2.0 – Just what the patient ordered?

Susana Hsu — Tue, 15 Jul 2008 14:59:52 -0400

Web 2.0 is the buzzword on everyone’s minds, but how is it changing the game for health care?

The Internet is rapidly evolving from an environment where static pages exist for people to search and read information (a.k.a. Web 1.0) to one where users from all walks of life can create and share content online.

Patients now have the potential to go beyond just researching health facts on the web to actively sharing their experiences with each other – not only for emotional support but also to benefit from collective intelligence and gain clinical knowledge from each other. They increasingly have the ability to take greater control and play a larger role in the management of their own health.

Not surprisingly, a recent survey showed that patients are starting to consult Internet-based resources, including social media, more than they consult their physicians.

59% resort to Internet-based resources (including Web sites, search engines, online advertisements, blogs, forums, and social networks) for health- and wellness-related information (versus 55% who ask their physician)

Source: iCrossing

Physicians themselves are starting to utilize Web 2.0 as well. Sermo.com is an example of a social networking site exclusively for doctors which enables members to come together to share their knowledge in order to “accelerating the emergence of trends and new insights on medications, devices and treatments.”

Here is a small sample of the many health-related Web 2.0 resources out there:

Wikis	AskDrWiki, FluWiki, Clinical Informatics Wiki, WiserWiki
Blogs	Kevin M.D., DiabetesMine, Running a Hospital, Clinical Cases and Images
Social Networks	Sermo, Patientslikeme, MyCancerPlace, DailyStrength
Video Sharing	ICYou
Online Forums	Google Health Groups, Revolution Health Groups, HealthyCanada
Podcasts	Johns Hopkins Medicine Podcasts, NIH Podcasts, CDC Travelers Health Podcasts, dLife

It is clear that Web 2.0’s popularity will start to change the way in which patients, physicians and researchers collaborate and learn about illnesses and therapies, and manage patient health.

Web 2.0 holds great potential for both health care professionals and patients alike, but it remains to be seen how issues surrounding privacy and security, which are especially heightened in the health care space, will be overcome.

Read my full article on Health 2.0.

Ireland uses patent wristbands with barcodes

Toby Ward — Thu, 21 Feb 2008 13:39:08 -0500

IT is a significant driver for a safer and more efficient healthcare system in Ireland, funded to the tune of €17bn per year. In a move to make the system more efficient and to better track patients through the system, the system is beginning to use patient wristbands with barcodes that provide full access to the patients key information (see Taking the pulse, reported on the SiliconRepublic.com).

"In times of financial prudence, the budget for infrastructure such as IT is often cut to the quick in an attempt to rein in costs. Conversely, industry observers say now is the time to spend because IT has been proven to save money and drive efficiencies. Despite past technology projects going very publicly awry, the HSE is proceeding with smaller projects that it hopes will improve patient care and increase efficiencies.

ID technology integrator Zetes is involved in a project for patient wristbands with two-dimensional (data matrix) barcodes. The wristband contains key demographic information that includes the patient’s name, surname, date of birth, sex and hospital number. The information is now electronically transferable for use by a PDA-type device, mobile computer or any electronic interface.

“We did this for a hospital in Roscommon that wanted to improve its phlebotomy practices. It previously had to print labels and it now uses electronic wristbands,” explains Barry Long, sales manager with Zetes. “This has two advantages: electronic transfer of information and the details on the wristband is consistent and the same as on the hospital’s system.” Barcoding is a fundamental building block in the installation of wireless networks in hospitals and many hospitals throughout the country are either putting in or piloting the technology, according to Long."

Read the full article Taking the pulse.

U.S. Health IT Lags

Toby Ward — Wed, 01 Aug 2007 16:54:08 -0400

According to statistics from the Centers for Disease Control and Prevention, only 1 in 10 U.S. physicians in 2005 were using systems that included prescription and diagnostic test orders, test results and physician notes, which are vital to a complete health information network. That number may be in the rise, but it still lags behind demand and the pace of technology.

“As a result, the United States—which had a key role in the creation of personal computers, the rise of the consumer Internet, the mapping of the human genome and using technology to cut costs—lags Denmark, the Netherlands and some other industrialized nations when it comes to moving medical records into the digital age, according to the Commonwealth Fund, a healthcare-focused private foundation in New York,” writes Lisa Baertlein with Reuters in U.S. Health IT Lags on eWeek.com

Insurance companies, which have come under fire for cherry picking the healthiest patients or limiting payments to members, make up another sector that stands to benefit from digital information to find the most effective treatments.

The United States plans to develop a national network of health information by 2014, and the European Union has called for every member state to create a system of electronic medical records, according to PricewaterhouseCoopers' recent Pharma 2020 report.

AND THE WINNER IS ... DENMARK

Denmark leads the pack among European and English-speaking countries when it comes to using digital information to deliver health care, according to the Commonwealth Fund.

The Danish government provides health care for its citizens and most of their health information is kept in a single system that can be accessed and updated by an individual's primary care doctor and other medical professionals.

Anyone who has personally—or through an acquaintance or family member—grappled with a complex or terminal medical condition knows just how difficult it can be to keep track of specialist visits, hospital stays and prescription drugs—and how valuable it is for doctors, patients and family members to have immediate access to complete records during a health crisis.

None of this of course is a surprise. In a June 2006 article, Health IT struggles echo 19th century challenges (Government Health IT), John Pulley writes, “Up to 100,000 Americans die each year from preventable medical errors, according to estimates released by the Institute of Medicine in 2000. Subsequent studies have estimated twice as many such deaths, with medical errors killing more people every year than breast cancer, AIDS or wrecks involving motor vehicles.”

“One in every five of those fatal errors results from a lack of immediate access to patient health care information, said Jodi Daniel, the director of policy and research for the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology.”

While the “war on terror” continues to dominate the U.S. administration’s policy, priorities such as Health IT will continue lag and fall further behind European counterparts.

Technology to improve stroke care to remote areas

Cathy McKnight — Mon, 11 Jun 2007 09:04:55 -0400

Canadian living in rural and remote areas of Alberta will have better access to stroke diagnosis and treatment services through an investment of close to $1.1 million from Canada Health Infoway in the province-wide network that links stroke specialists and patients.

The Telestroke program will provide funding to participating health regions to expand the use of videoconferencing technology and other specialized equipment to enable direct medical consultation without the need to have the health professional and patient in the same place.

"Our Telestroke program has already demonstrated many examples of faster diagnosis and treatment, as well as improved outcomes for stroke patients in rural Alberta," said Dave Hancock, Minister of Health and Wellness. "This investment will build on our strong Telehealth network that bridges the physical distance between patients and specialist services."

The Telestroke program supports the Alberta Provincial Stroke Strategy, which is a collaborative partnership between government, regional health authorities and the Alberta Heart and Stroke Foundation to reduce the rate of strokes and improve acute treatment, rehabilitation care and outcomes for patients.

"Alberta's Telestroke program is one of many revolutionary initiatives that are modernizing patient care across Canada," said Richard Alvarez, President and CEO of Canada Health Infoway, a not-for-profit organization which invests with public sector partners to accelerate electronic health records across Canada. "This project will provide patients with quick access to stroke diagnosis and treatment closer to home, resulting in improved outcomes and increased efficiency."

Improving stroke care supports Premier Ed Stelmach's plan to improve Albertans' quality of life. Other priorities for the government are to: govern with integrity and transparency, manage growth pressures, build a stronger Alberta and provide safe and secure communities.

Sale - hip replacements only $25K

Cathy McKnight — Mon, 23 Apr 2007 14:03:41 -0400

It is not like going to the grocery store where your choices range from no-name sale items to organic delicacies. Most North Americans, particularly those not living in metropolitan areas, don’t have much choice in where their advanced medical care needs are addressed, and thus may not give the cost of that care much thought. But even with a choice of hospitals in their immediate area, or the means to seek care out of state or province, most people know more about the quality and pricing of their cars than their health care. This is largely due to health care costs are being covered or at least partially financed by intermediaries like health insurers and employers.

In 2005 the U.S. government, the biggest purchaser of health care in the United States, began posting what Medicare pays hospitals for common procedures like heart surgeries and knee replacements, in an effort to educate Americans on the price and quality of their health care.

Tennessee has taken this to the next step and today launched Tennessee Hospitals Inform. The new site lists average prices for common procedures at most of the state's 136 acute-care hospitals.

This move by Tennessee’s hospitals to tell patients upfront about prices is part of a larger trend toward consumer-driven health care — high-deductible plans, often combined with savings accounts, which require people to pay more money out of pocket.

Today people generally don't have a clue what the health care they are consuming costs, nor do they have any means to be able to compare. And with patients making more decisions about their medical care, several commercial Web sites and sites run by insurers, have begun posting some price information online to fill this knowledge gap.

Hamilton Health connecting around the world

Cathy McKnight — Mon, 02 Apr 2007 05:00:00 -0400

Hamilton Health Sciences' orthopedic surgeon Dr. Justin deBeer was halfway around the world in Taipei, Taiwan but wanted to be able to keep tabs on his patients back in Canada. What in the past would have been a next to impossible proposition was actually done quickly and easily thanks to ClinicalConnect – a web-based portal for physicians that brings together data from three of the hospital’s most commonly used clinical software systems in an electronic health record format.

Hamilton Health Sciences worked with Medseek to design and implement the ClinicalConnect portal, but also engaged physicians from a variety of disciplines to offer input and drive the creation of the final product. Since Meditech is the most widely used information system at Hamilton Health Sciences, it was the first to be merged into the ClinicalConnect environment. ClinicalConnect offers a user-friendly view of the Meditech information, which ranges from admission information to lab results, and allows physicians to view the information simply by signing on to ClinicalConnect.

The next step involved adding views of patient records, stored in a system called Sovera. Currently the charts are scanned and merely displayed through ClinicalConnect, however, the portal does allow physicians to view the information and also indicates the number of chart deficiencies that need to be resolved. By the end of this year, physicians will be able to access Sovera directly through ClinicalConnect, which will enable them to interact with patient information in real time and directly resolve any chart deficiencies.
In the future, physicians will have the option to e-edit and e-sign Meditech-based charts in the portal, and the updates will be passed back to the Meditech system. When this feature is available in the portal, it will also be available via PDAs.

Adding PACS to the system proved to be a tremendous enhancement, since it enables physicians to view X-rays from the same system that houses other clinical information about their patients. And by signing on to one system, physicians can access and interact with all of this information. They can also customize their views and pick and choose which information they want to see and when.

“Our ClinicalConnect portal gives physicians and other clinicians secure, real-time access to electronic patient records. Whether they are at the hospital or elsewhere, our physicians can quickly access all clinical reports, lab results, PACS images, pharmacy medication lists and much more,” said Dale Anderson, information and communications technology manager of projects and e-Health solutions at Hamilton Health Sciences.

As Hamilton Health Sciences expands the wireless network within its four sites, ClinicalConnect will become even more valuable. Already, some physicians have been piloting wireless applications of the system on PDAs in certain areas of the hospital. They’ve got access to all available patient information when they are seeing the patient. Patients are also able to ask questions about particular tests and procedures when they are with their doctor and do not have to wait for results to be retrieved from another computer or system.

The remote access to patient information through ClinicalConnect enables healthcare providers him to use remote Internet access to call up the patient’s information, including X-ray images and blood work, to check up on patients.

Originally published in Canadian Healthcare Technology

iPod, iMac, iECG!

Cathy McKnight — Thu, 29 Mar 2007 06:00:00 -0400

iPods are everywhere - on running tracks, subways, elevators, even at many dinner tables if the family happens to include a member that is between the ages of 10 and 18 years of age, and medical schools?!

Cardiologist Michael Barrett presented the findings from a Temple University study that showed listening to different heart sounds on an iPod at least 400 times is an effective way to improve a doctor's ability to detect a problem.

The study had 149 medical students listened 400 times to the five most frequent heart murmurs over a 90 minute period. This single practice session improved the rate of detection by stethoscope from 40 to 80 percent among generalists.

The ability to detect heart anomalies is essential to finding a range of cardiac problems and can reduce the number of unnecessary tests like echocardiograms and stress tests, Barrett said.

Amercians concerned about data privacy

Cathy McKnight — Wed, 28 Mar 2007 21:39:46 -0400

Results from a Harris Interactive January 2007 online poll of 2,237 U.S. adults show that half of the respondents feel that patients have lost control over how their medical records are used by organizations such as life insurance companies, employers and government health agencies.

Additionally, 17% say they have withheld information from their health care providers because of worries the information might be disclosed. That number rises to 21% for participants who describe their health to be fair or poor.

The poll also found that 70% of respondents are satisfied with the way doctors and hospitals protect the confidentiality and security of personal health information. Further, 63% of respondents agree that use of computers to record and share medical records can be accomplished without jeopardizing patient privacy rights.

For more information, go to harrisinteractive.com.

Alberta gets serious about telehealth

Cathy McKnight — Mon, 12 Mar 2007 08:20:54 -0400

Albertans living in rural and remote areas will have better access to healthcare services such as chronic disease management, mental-health care, cancer care and hospital follow up, thanks to technology that links specialists and patients.

The Clinical Telehealth Innovation Program will provide more than $3.4 million in new funding for 32 projects over the next two years, with the Alberta government and Canada Health Infoway investing more than $1.7 million each.

Through the use of videoconferencing technology and specialized medical equipment, telehealth enables direct medical consultation without the need to have the health professional and patient in the same place.

As part of Premier Ed Stelmach’s commitment to Improving Albertans’ quality of life, all nine health regions, as well as the Alberta Mental Health Board and the Alberta Cancer Board, have received increased funding to expand access through telehealth projects.

Alberta’s telehealth network is one of the largest in Canada and includes more than 200 telehealth sites across the province. Among the many benefits of telehealth are:

· Convenient, confidential and secure access to distant clinical specialist expertise and care, particularly for residents living in rural and remote areas.

· Improved clinical and education support for healthcare professionals in their own community.

Some of the 32 projects under development include:

· Rural Palliative

· Chronic Disease Management and Enhanced Transitional Patient Care

· Tele-rehabilitation: Outpatient Care for Stroke Patients

· Surgical Services by Telehealth Closer to Home (Pre-Op and Post-Op)

· Community Discharge Planning & Follow-Up

· Enhancing Discharge for Children

· Teleorthopedic Consultations

“The telehealth network is an outstanding example of how innovation can improve access to healthcare services in Canada,” said Richard Alvarez, President and CEO of Canada Health Infoway. “Congratulations to Alberta for recognizing the potential of telehealth and driving it forward for the benefit of patients across the province.”

Orginally reported in Canadian Healthcare Technology

An EMR Success Story

Cathy McKnight — Fri, 09 Mar 2007 09:43:24 -0500

Giving up pens and paper charts for PDAs and laptops is a struggle for many hospitals across North America. While some medical facilities have sprinted to meet the online record finish line, others are taking the marathon approach to establishing their electronic database of patients' medical records.

The prize at the end of this EMR race:

fewer medical errors,

earlier diagnoses and

improved patient care.

The hurdles along the route:

- cost of technology,

- time

- resources and

- an aversion and reluctance to move into the intricacies of the electronic world.

According to a Citrix Systems Inc. survey approximately 30% of private-sector health care providers are just in the planning stage of implementing an electronic medical records system. The report includes physicians' offices and hospitals.

Case study in EMR Success

There are a few hospitals that have seen the light and are well ahead of the pack in the EMR race. Toronto’s Hospital for Sick Children is one such facility where they now scan all paper charts into electronic format within 24 to 48 hours of the patient’s visit.

Sick Kids doctors and adminstrators alike recognised that with patients often moving between different areas of the hospital during their visit, it was a challenge to ensure paper-based records and files were in the right place at the right time.

Adding another layer to the paper problem is where to keep all the physical files. With an estimated 60,000 charts per year for research purposes alone, and nearly 50,000 emergency visits a year, storing and accessing those files was expensive, according to Debi Senger, director of health records at the Sick Kids Hospital.

The solution to simplify and streamline patient record management, and do so in a way that would be easy for time-strapped medical staff to use, was to scan the physical documents into an EPC – electronic patient chart using Synergize™ Electronic Patient Chart (EPC) system based on Microsoft® SQL Server™2000.

Sick Kids patient records from May 2000 onward are now available on EPC. An added bonus on top of all the benefits mentioned above is that because data is stored in an electronic format, multiple users can view patient records simultaneously and instantly via hospital workstations, as opposed to everyone vying for a single paper chart.

eHealth tools for teens and youth

Cathy McKnight — Fri, 02 Mar 2007 11:04:49 -0500

The Internet, e-mail and instant messaging are popular forms of communication for teens. Children between the ages of 13 and 19 are the group most likely to use the computer, a study published in the December 2006 issue of Paediatrics. The study also found that as many as two-thirds of teenage girls look for health information on the Web.

Another study published in 2005 by Pew Internet and American Life Project found that 87 percent of American teens age 12 to 17 used the Internet in 2004, up from 73 percent in 2000. The frequency of teens' online usage rose 51 percent in that time frame, and the number of teens who report they go online daily was up from 42 percent in 2000. Pew also found 51 percent of online teens live in homes with broadband Internet access.

Knowing this, its surprising there aren’t more teen focused health sites out there. Now whether the results from a quick Google search is a truly reflective of missing sites, or more a case of poor site taxonomy and SOA best practices, that remains a mystery. Some of the sites that did turn up after digging a little deeper, and are positive resources for teens include:

eHealth 4 Teens – provides a variety of information on health topics, local activities, important resources and referral lines. EH4T features interactive games, quizzes, personal health assessments and other services. The site was created with help of high school students and staff from the Multnomah County Health Department School-Based Health Center Program in Portland, Oregon, with the purpose of addressing the health care needs of Multnomah County’s most vulnerable youth.

TeensHealth - was created in 1995 for teens looking for honest, accurate information and advice about health, relationships, and growing up. A safe, private place that's accessible 24 hours a day to get the doctor-approved info teens need to understand the changes that they may be going through. Created by The Nemours Foundation's Center for Children's Health Media, TeensHealth and KidsHealth provide teens and families with accurate, up-to-date, and jargon-free health information they can use.

Learn to be healthy - is an online health science learning site designed to provide students, kindergarten through grade six, and their teachers, resources on important health topics. With separate “student” and “educator” areas, the site contains comprehensive lesson plans, interactive games and activities, webquests and more. The goal of the site is to inspire children – and their families – to make healthy choices that will last a lifetime.

AADAC for Youth and Kids – with two separate sites dedicated to the different age brackets, Alberta’s Alcohol and Drug Addictions Commission provides more than just drug and alcohol related information. These sites also address important topics such as tobacco use, bullying and gambling, as well as feelings, friendships and anger management. AADAC provides useful resources, as well as games, stories and interactive tools to help kids, teens, and their families be informed on addictions related topics.

As will most good things, come the bad. An even further delve into health related sites teens visit found the frightened end of the information spectrum. Website that teach readers how to be a successful anorexic, bulimic or bully. It is true, believe it or not. (URLs for these sites have intentionally been omitted from this post.)

So while many of our kids out shine us when it comes to navigating their way around the web, it is important, as parents, that we don’t deny our kids access to the Internet, but instead learn more about what sites they're visiting and talk with them about what they are reading and answer questions they may have. Better yet, surf the web together, who knows, as parents, we will probably learn a thing or two.

PHRs – keeping up with the move to EHRs

Cathy McKnight — Mon, 26 Feb 2007 15:15:25 -0500

So what exactly has happened to the rows upon rows of files that use to dominate the medical offices of our family physicians and specialists? Off site storage? Basement? Burned? Lost? No one knows for sure. But what we do know is that now your life, at least your medical life, resides in the memory banks of computer or two. Feel safe knowing that?

With the push on around the world (Canada, US, UK, Europe …) to move our medical history from paper to microchip via EHRs (electronic health records) it is more important than ever to make sure that your doctors are not the only ones who have this important data. Keeping a personal health record or PHR of your own medical history and particulars, and keeping this information in a safe place, will ensure that if or when a cyber-glitch occurs at your doctor’s office, as we all know they can, these important details won’t be lost forever.

Setting up a PHR for you or someone you provide care for (child, parent …)

1. Get the details from the doctors. This can either be in electronic or paper format. You may have to fill out a form for them to release the information. And yes, even though it is your information, they may charge you for photocopying the information or saving it to a disc for you. And just to make it a little worse, you may have to wait a couple of months to receive your information.

2. Review the information and then store it somewhere safe. Keep all the information in one place.

3. Make back up copies of any electronic files. Using a CD or USB drive makes it easy to share your medical information with new care givers.

4. Keep the data up to date. To avoid further costs or missing information, update the data on your own with medical appointments, prescriptions, OTC drugs … Consolidate key information – doctors (GP, allergist, ENT …) contact information, blood type, health insurance information … into a summary page for quick referencing.

5. If you have any existing medical conditions, are taking medication or have any potentially life threatening allergies (drugs, foods, latex …) keep this information on a wallet size card and carry it with you. Or better yet, register with services like MedicalAlert and wear an information bracelet or charm.

6. Keep the information safe and secure. Share your health record only with those you want to see it.

There are many ways to maintain your PHR:

· Keep it in a file folder or binder.

· Transfer the information to a computer disk or USB.

· Online services. There are many intranet offerings that with secure servers that you access from your computer and on which you enter your information. Some of these are free, and for others you may have to pay a fee or subscription.

Myphr.com, while not endorsing or selling any PHR tools or services, offers a searchable data base of PHR tools ad services for individuals to review.

The following is a list of details that should be included in your PHR according to myphr.com:

· Personal identification, including name, birth date, and SSN or SIN

· People to contact in case of emergency

· Names, addresses, and phone numbers of your physician, dentist, and other specialists

· Health insurance information

· Living wills and advance directives

· Organ donor authorization

· A list and dates of significant illnesses and surgeries

· Current medications and dosages

· Immunizations and their dates

· Allergies

· Important events, dates, and hereditary conditions in your family history

· A recent physical examination

· Opinions of specialists

· Important tests results

· Eye and dental records

· Correspondence between you and your provider(s)

· Permission forms for release of information, operations, and other medical procedures

· Any information you want to include about your health – such as your exercise regimen, any herbal medications you take and any counselling you may receive.

If your doctor keeps electronic health records, they may have a patient gateway that will allow you to view and track some of your health information online. While this is a great start to giving you access to your information, it is not your complete personal health record, and you should still be proactive collecting the health information you need.

Picking the best healthcare provider

Cathy McKnight — Wed, 21 Feb 2007 09:35:11 -0500

Now consumers don’t have to let their fingers do the walking to pick a doctor, specialist or healthcare facility. Thanks to services like Healthgrades.com, MDNationwide.org and RateMDs.com you can make an informed choice by logging in online.

Each of these web based evaluation and rating services collect information in different ways. Some services are free, while others provide detail on a pay-per-service basis.

Healthgrades.com compiles data from dozens of independent public and private sources and translates it into easily understandable, objective report card ratings on the healthcare providers in question. Scoring is provided for physicians, hospitals and nursing homes, with information being updated quarterly, annually and monthly respectively. The NASDAQ listed Health Grades Inc. information is targeted for consumer, industry and insurance use, with more than 12 million site hits last year. High level hospital ratings are free, all other reports are offered on a pay-per-service basis.

MDNationwide.org has been around since 2002. A privately held for-profit Research & Information Company, they specialize in researching and identifying the top medical doctors in the US, and providing comprehensive doctor background reports. Ongoing surveying of and communications with doctors, credential agencies, medical boards, medical societies, and other agencies garner the data provided via this site. This is a pay for service offering, with pricing starting at $9.99 USD.

RateMDs.com is a free service that sources its ratings directly from consumers. What it will tell you is on a scale of one (poor) to five (excellent) whether the doctor you are considering was perceived as punctual, helpful and knowledgeable by those who have rated them. There is also a section for consumers entering their score to provide ad hoc comments. There is a disclaimer right on the site that “ratings and comments have not been substantiated by RateMDs.com”. So the scoring is not exactly impartial or even objective.

So whether you looking for a family physician or a specialist for a second opinion, details to help you make a more informed decision are just a click away.

US wide EHRs by 2012

Cathy McKnight — Fri, 16 Feb 2007 08:57:06 -0500

Not sold on having your intimate medical details existing out there, somewhere, in cyber space? Well, if you live in the United States it appears you have five years to reconcile those concerns if New York mayor Michael Bloomberg has his way.

At a major health policy conference earlier this week, Bloomberg called for universal electronic health records by 2012.

According to NY’s mayor “In this day and age, there is no excuse for any more delay," he said. "So let's set this national goal: Five years from today, every doctor's office, clinic and hospital in America that accepts Medicaid and Medicare must be using prevention-oriented electronic health records."

EHR (electronic health records) are computerized versions of the bulky paper files occupying shelves in doctors' offices and hospitals. Supporters of ridding medical offices and facilities of antiquated paper files say they result in medical errors and are difficult to transfer between healthcare providers. Getting to 100% adoption is going to be an uphill batter with the medical industry’s reputation for being behind the times in regard to the adoption of technology in comparison to other industries. Another factor is that cities alone do not have the resources to fix this problem.

Bloomberg suggest that the federal government can help achieve the five-year goal, by giving doctors and hospitals money to buy computers, as well as restructuring Medicare and Medicaid reimbursement to reward providers who can show they are using the records to focus on prevention, and emphasizing primary care.

Adoption of streamlined records should be part of an overall shift of emphasis away from expensive procedures to inexpensive preventive measures, he said. "What we're doing is encouraging expensive forms of treatment and discouraging less-costly disease prevention. We're breaking the bank and certainly not getting our money's worth.

Bloomberg estimated the total cost of the transition at $20 billion, which he said was a small sum compared to the trillions of dollars currently spent on healthcare in the United States. New York City has already invested heavily in electronic health records, becoming one of the first cities to implement them in public hospitals and community health centers, the mayor said. Last year the city government committed $27 million to help make the technology needed for the records affordable to doctors.

Earlier this month North Adams, Massachusetts planned to launch a citywide computer health network to become the first city in the U.S. where any physician and many nurses in the city can access the electronic health records from their offices, North Adams Regional Hospital or the visiting nurses association.

eHealth Literacy

Cathy McKnight — Tue, 13 Feb 2007 15:54:00 -0500

In The e-Health Landscape: A Terrain Map of Emerging Information and Communication Technologies in Health and Health Care, Thomas Eng defines ehealth as “the use of emerging information and communication technology, especially the Internet, to improve or enable health and health care.” Now the questions that beg to be asked are: Is the world’s population able to take advantage of this relatively new lane in the information highway? and; Do we have the necessary eHealth literacy?

Cameron D Norman and Harvey A Skinner define the concept of eHealth literacy as ”the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem.” In their paper, eHealth Literacy: Essential Skills for Consumer Health in a Networked World, these authors present a model of eHealth literacy made up of different literacy types, and identify what basics are needed to get the most out of eHealth tools.

As Norman and Skinner explain, electronic health tools provide little value if the intended users don’t possess the know-how to use them. Recent statistics have North American adults reading at literacy level of approximately 50% of where it needs to be to interact within our text-message-laden environment. Which, if looked at from an eHealth point of view, translates into half the targeted audience for health, ehealth and health related promotions missing the message, and health advantage opportunity.

Realistically, at a minimum, any individual looking to interact in a consumer-targeted eHealth environment needs at least access to and working knowledge of computers, fundamental reading and writing skills, and the ability to interpret the often scientific laden language used on online ehealth related sites. And at this point in time it just isn’t clear that most of the population have these basics in their skill set.

So does that mean that eHealth initiatives are doomed? Or that what already exists in cyberspace is a waste? No. What it means is that consumer targeted eHealth sites have to take it down a notch in technical terms and spell it out as clearly as possible, leaving the medical lingo to the medical profession targeted sites. And look at it is that consumers want and would benefit the most from. A good place to start would be sites that store EHR (electronic health records) sites that are secure and easy to manage, and condition-focused sites that use simple language and focus on providing information the patient needs, not what the doctors want to tell them.

Canadian doctors speak up on IT

Cathy McKnight — Fri, 09 Feb 2007 09:46:43 -0500

Canada’s three major national medical organizations announced today an agreement to undertake a second edition of the National Physician Survey (NPS) in 2007. The College of Family Physicians of Canada (CFPC), The Canadian Medical Association (CMA) and The Royal College of Physicians and Surgeons of Canada (RCPSC) are building on the success of a 2004 Survey that drew national and international attention for its scope and for the valuable insight it provided into the future of medicine in this country.

The 2007 survey will provide important data on the use of information technologies by doctors, as well as medical education and practice, to help educators, policy makers and planners make informed decisions.

The National Physician Survey is unique in the world in terms of the range of current and future physicians who will be surveyed. Questionnaires will be sent to all practising family doctors and other specialist physicians and surgeons in the country, as well as second-year medical residents and all medical students. In total, more than 73,000 questionnaires will be distributed starting in January of 2007.

The NPS 2007 will provide an in-depth look at how physicians are currently working collaboratively and the impediments they face in providing care to their patients. The results will also provide a glimpse into the future of medicine in Canada by describing the factors that are shaping the future educational and career intentions of medical students and residents. The highlights of the NPS 2007 will be released to the public and key stakeholders in a series of public announcements beginning in November of 2007.

The NPS also maintains a website at nationalphysiciansurvey.ca, where the 2004 results can be accessed today and where the 2007 results will eventually be posted. The NPS has been made possible through the financial contributions of the Canadian Medical Association, The College of Family Physicians of Canada, The Royal College of Physicians and Surgeons of Canada and the Canadian Institute for Health Information.