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How Complicated Is It to Simplify Medication Adherence?

Posted on November 17, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Of all the things that irrationally inflate health costs, one of the top concerns is people who just don’t take their prescribed medications. Medication adherence doesn’t sound like a high-tech issue, but a lot of interesting technology is being thrown at the problem.

One pharmacist (obviously harboring an interest in increasing orders) estimated that we’d save 290 billion dollars a year if everybody took the medications prescribed for them. But don’t dismiss their claim as self-serving–the Centers for Disease Control suggests they may be right. It also says that half of all medications are discontinued too early. As the “fee for value” movement starts extending to the performance of medications, concerns that patients actually follow through on prescriptions will increase.

At the recent Connected Health Conference I talked to several companies taking on the difficult adherence problem from different angles. Medisafe aids patients in self-monitoring, Insightfil creates convenient packaging that groups pills the ways patients take them, and Dose doles out medication at prescribed times.

Medisafe is one of a wave of firms that address medication adherence, representing an advance over jotting down daily practices in a paper journal. These services share a good deal in common with other solutions in the marketplace that carry out patient monitoring, care planning, and the patient-centered medical home. In all these areas, services boast of tracking behavior, providing feedback to both patients and clinicians, promoting communication, and similar aspects of the connected health vision.

Medisafe handles patients’ nonadherence in multiple ways, including importing the patient’s medication list, along with vital signs such as blood pressure. Visualizations help both the patient and the doctor see the relationship between taking medication and the relevant vital signs. Patients can manage their doctor office visits or when they have been assigned a change in medication, and monitor the effects of such events on adherence through Medisafe. Finally, doctors will be able to compare data on patients within their practices, grouping them by condition, by medication taken, by demographics, or by behavior traits.

Other medication solutions try to reduce the burden of compliance that falls on the patient–or to look at it in another way, reduce the patient’s discretion. At something of an extreme, Proteus inserts a tiny radio device into each pill and makes the patient wear a patch that can detect the presence of the pill in the body. People have suggested one or two use cases for this intrusive system (for instance, during a drug trial, to guarantee accuracy) but in general, treating patients like criminals doesn’t encourage healthy behavior.

A lot of people, especially the elderly and those with the most severe medical conditions, need so many pills and capsules that it’s hard to remember which ones to take, and when. I’ve seen relatives loading little pillboxes every Sunday morning with the pills for the upcoming week.

Insightfil hopes to take all the manual labor, and consequent chances for error, out of this process. It ships each person a customized blister pack with a week’s worth of medications, offering up to four compartments per day to cover different times. This may seem like a simple problem, but it’s actually a major logistical feat.

First, according to founder and CEO Ted Acworth, his company had to develop a robot that could recognize different pills and accurately load them into the blister packs. Then they had to find a pharmacy with nationwide reach and room in its warehouse for the robot.

Dose solves the problem a different way, through a dispenser into which a patient or caregiver can pour bottles of pills. The dispenser, which has been configured to know the patient’s medication regimen, can automatically separate the pills and release them at the right time.

Once the pills are in the box, control can be removed from the patient. This can be important for doling out opiates or other drugs that can be dangerous or that patients have a tendency to abuse.

Dose’s dispenser is a very smart machine, supporting some of other goals of connected health I mentioned. Clinicians, caregivers, and patients can get alerts about doses taken or missed. The device has bi-directional programming capabilities with a web portal and mobile app, and clinicians can change regimens over the Internet. Biometric devices can be attached to let users map medication adherence to vital signs, or to report a user’s exercise and eating habits. The device’s forward facing camera can be used for scanning the barcode of a pill bottle, as well as for video consultations with a clinician. Along with these features, the device is integrated with an FDA Drug Database and therefore an accurate drug list, along with information about potential drug interactions is readily available.

On many levels, then, advanced technology can help patients with the apparently simple problem of opening a bottle at the right time and popping a pill in their mouths. This article has been a limited look at the problem–I haven’t dealt with over-prescription or side effects, but just the question of how to get patients to take the drugs that are understood to improve their health. We’ll see over time which of these solutions–perhaps all of them at different times–can help of hundreds of millions who regularly take prescription drugs.

Complex Technologies Lurk Within Simple Interfaces – A Lesson for Health Care

Posted on November 13, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Technologists are justly proud of the complex problems they solve. What’s hardest is hiding that complexity from the end-user. When a great magician performs, the audience is not aware of the excruciating practice he put into the Disappearing Coin trick (I have tried to learn it). In the same, complex analytics and personalization may have to hide behind a simple one-button device.

The demands placed by health consumers on health technology were laid out persuasively by David Inns, CEO of GreatCall, at the recent Connected Health Conference. His reasoning could be proposed as a kind of classic syllogism:

  • Major premise: technologies continually advance, whereas people are most comfortable with the technologies they learned when young;

  • Minor premise: health needs are concentrated among the elderly or middle-aged;

  • Conclusion: the people most in need of health technology will not be comfortable with the latest technology.

Translated into practical advice, this means that any personal health technology must adapt to multiple interfaces. If an individual has the latest iPhone, that’s great. If she prefers a simple flip phone, let her use that. And if she has nothing and is willing to tolerate only a device she wears around the neck with a button, let her have it.

Let’s shift gears for a moment (for those readers who remember manual transmissions). What does GreatCall offer its clients?

GreatCall is a typical–though technologically advanced–component of a a wellness program or patient-centered health medical home. It allows older adults or disabled people to keep in touch with caregivers, both family members and professional caregivers. The individual obtains from GreatCall a device with 5 Star Service that he or she keeps close at hand. GreatCall learns the individual’s habits: it knows what a visit to the doctor looks like, a Sunday in church, etc. The software that powers the GreatCall Link app notices when something worrisome happens, such as a person staying in bed very late, not getting out of the house regularly, or leaving the house at odd times. It starts by notifying the family caregiver.

If a change has been flagged as urgent and a family caregiver fails to respond, GreatCall can escalate the issue to a 5 Star operator who can assist with such situations on a 24/7 basis. Everyday behaviors, such as medication adherence, can also be monitored.

The GreatCall Link app can also give individuals and their caregivers summaries of the individual’s status. These summaries are not presented as numerical lists or even two-dimensional charts, which would be hard for non-techies to understand. Instead, GreatCall creates a written paragraph that summarizes whether the older adult has engaged in more activity or less, and similar information.

What technologies are necessary for GreatCall to carry out its mission? First, there must be ways for the individual to communicate easily with his or her device. Even a flip phone can be enhanced with secure apps to accept messages from users.

GPS is also a critical component, but GreatCall adds another layer of positioning–A-GPS or assisted GPS. First, it enhances satellite-based GPS with the precision provided by cell towers when someone is indoors and satellites can’t provide location information. Second, GreatCall tracks changes in location over time to account for errors. A GPS system may report that a patient is two blocks from her apartment at 2:00 in the morning when actually she is safe in bed. Data collection and analytics allows GreatCall to avoid a panic call–but all of this sophistication lies behind a simple interface.

In the cloud, GreatCall stores the necessary information to match a user’s location with her favorite haunts and to contact caregivers or family members when necessary. Data is carefully protected and not shared with anyone outside GreatCall.

I’ve been intrigued by the GreatCall service because it combines fancy analytical technology with an interface that adapts to the needs of the user, whether a tech-savvy active ager or a 90-year old with more serious cognitive or health issues. They represent an inspiring story of investigating their users, understanding them empathetically, and offering their advanced technologies in a service that is likely to win adoption. Every app developer should carry out research like this.

Connected Health Conference Tops Itself–But How Broad is Adoption? Part 3 of 3

Posted on November 9, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The previous section of this article looked at advances in health care, as well as some warnings about their efficacy at the Connected Health Conference. In sessions about experiments in altering care, people managing the new programs stressed that commitment and expertise are not enough; these programs call for structural and culture change within organizations. One speaker pointed out that quality programs must assess not just an individual clinician, but the whole system that intervenes in patient care.

In its 12th year, the Connected Health Symposium is more successful than ever: the most attendees, most exhibitors, and biggest sponsorship ever. More to the point, I noticed more sessions this year focusig on immediate, practical logistics of getting new programs in place. But a number of adoption issues remain:

  • Many pilot programs weren’t designed to be sustainable and scalable; even when successful, they weren’t adopted by the larger organization. Some speakers blamed these dead ends on a lack of an individual champion, others on the lack of organizational structures for promoting change.

  • Payers expect to see a return on investment within three years, but patients take much longer to show benefits of health. This isn’t rational. One speaker pointed out that while an insurer’s patients will move on, it will gain new patients that another insurer invested in. So a long-term investment will raise all boats. However, the fossilized financial models remain in place

  • Cost savings can slip away from you. Robert Perl, executive director and CEO of The Permanente Medical Group, reported that the use of electronic health records at Kaiser Permanente improved care but did not lower costs. The savings all went into the very expensive EHR itself, as well as the extra time physicians had to spend entering data because of the EHR’s design. But Kaiser chose to install Epic, so one could ask Dr. Perl why he expected the outcome to be any different.

  • It’s also disheartening to hear visitors from other countries. One would think that Britain and Canada, with their more broadly designed health care systems, would have solved the problems with data exchange and cost control that the U.S. struggles with. But reports suggest they’re just as bad off. The Canadian speaker said that after his PCP retired, no records were sent to his new one. Britain’s integration data efforts are still a “work in progress,” according to Anne Avidon, Head of Global Health Innovation at the Life Sciences Organisation of UK Trade & Investment. South Africa is also lagging on interoperability and data exchange. Semih Sen, a health care executive from Abu Dhabi, pointed out that “health care is the only industry left that isn’t global” and suggested some reforms, such as cross-border licenses.

My impression, overall, is that strides are being made in using data, engaging with individuals around their health needs, and providing innovative treatment options–but mostly outside the traditional institutions of health care. Those institutions are still trying to figure out how to achieve the organizational change that can permit them to participate in the health care revolution. And some are pouring money into experiments that they eventually abandon or can’t get financial benefit from because the environment is against them.

Next year, perhaps more institutions will find the way forward.

Connected Health Conference Tops Itself–But How Broad is Adoption? Part 1 of 3

Posted on November 5, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Along the teeming circuit of health care conferences that Boston enjoys year-round, a special place is occupied by the Connected Health Conference sponsored by Massachusetts giant Partners HealthCare. For 12 years this conference, shepherded by the spirited Joseph Kvedar, has shown Boston and the rest of the world what can be accomplished by the integration of data, technology, and clinical empathy.

But people I talked to at the conference were asking: where’s change visible in the health care field? Why aren’t we seeing these great things adopted throughout the country to support value-based care? The much-vaunted Accountable Care Organization model is failing to thrive, interoperability continues to elude medical sites, and consequently, health care costs are “eating” American’s incomes.

The way forward may have been shown by the two final keynotes of the conference, delivered by executives at Massachusetts General Hospital (one of the central institutions in Partners HealthCare and a destination for patients around the world).

Chief Clinical Officer Gregg Meyer referred to “punctuated evolution” to suggest that the health care field is at an “inflection point” where change is starting to happen fast. What makes this change hard is that two major initiatives separate most health care institutions from the fee-for-value world we want. One initiative focuses on organizational change and payment regimes, whereas the other involves wrenching changes to technology that track, record, and analyze what doctors and patients are doing.

I believe the reason many ACOs and other fee-for-value systems are failing (or at least not showing cost improvements) is that they took on the organizational change before they were ready with the technological parts. According to Meyer, Massachusetts General Hospital took on the technological change first, years before a payment system was offered that reimburses them for it.

Many speakers at the conference pointed to recent payment changes, such as Medicare Advantage, that promote fee-for-value. Programs along those lines in Massachusetts have shown modest headway against costs.

Even so, MGH has made only some early steps in health IT. Some doctors allow virtual visits, but it’s not done strategically and most providers don’t understand that such visits could reduce their workloads in the long run. Chief Health Information Officer O’Neil Britton said that the Epic EHR they installed still can’t accept streaming data. But he vaunted MGH’s growing use of genomics, wearables, video information delivery, and telehealth. The use of video was praised frequently at the conference for bringing information to people when they need it and reducing office visits that are costly and inconvenient for everyone.

The next section of this article will contrast techno-optimists with techno-skeptics and mention some advances reported at the conference.

Connected Health takes the stage at Partners symposium

Posted on October 28, 2014 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The Connected Health Symposium is not one of the larger health conferences, but it is one of the most respected. I met a number of leaders in health IT there who praised it for the conference scope and seriousness, and told me they were glad to see me there covering it.

Many issues in health IT and patient empowerment, however, are best learned not from any conference, but from the tussles and tears of everyday life. Let us hope no reader has undergone the personal experience of having her reports dismissed and of being misdiagnosed, as did several speakers at the conference.

But many of us have spent three hours on the phone with an insurer to approve a single medication shipment, or fought in vain to get the medical records that US law requires providers to give us, or watched our doctor fumble with his new EHR for fifteen minutes while trying to stay engaged with us.

It’s encouraging to see the progress of patient engagement at Massachusetts General Hospital, as reported by Gregg Meyer of Partners Healthcare System (the funder behind the Center for Connected Health that put on the symposium). But can small and rural providers struggling with cash flow join the movement?

These institutions would be comfortable using swyMe, a HIPAA-compliant telemedicine system that allows doctors to interview patients over everyday mobile devices and perhaps avoid a trip to the hospital. swyMe can also transmit audio and video from devices that EMTs can connect up to the phone. (Not many devices with the necessary hardware connectors are on the market, though.)

swyMe was one of the “innovators” highlighted in a conference demo. Jeffrey Urdan, COO of the company that makes it, told me later that he felt “low tech” compared to some of the fancy, expensive devices at the demo. But most of the providers in the US, and elsewhere, are more on swyMe’s level than theirs.

Another hurdle to forming connected teams that serve the patient is interoperability. A sign of the distance we have yet to come can be found in iCancerHealth, a service for cancer patients offered by Medocity. A free app is available to individuals, but the main integrated service is offered through providers or pharma companies doing clinical trials. The service includes such conveniences as medication tracking, treatment plans, a diary, audio and video connections to their physician, and even a way to form communities with other patients.

This is great, but iCancerHealth works with data from only one provider. This can be a limitation even for the few months that cancer patients typically use the service, and could certainly be a problem if the service were expanded to a broader range of illnesses. Similarly, there’s no seamless way to share data with patient communities; it has to be re-entered manually. Enhancing the service to encompass multiple providers would probably require wider adoption of electronic health record standards.

As an example of finding a creative solution to devices that lack interoperability, Mobile Diagnostic Services demonstrated an app that could photograph the display panel of a device, interpret the bars on the display to create digital data, and transmit the values to a health record in the cloud. This is a process well-known to computer programmers from thirty years ago as “screen scraping,” now relevant to the health industry.

One of the strengths of the Connected Health Symposium was the platform it gave to patients and doctors to express their frustrations with the old way of delivering care and the slow pace of change. The testimony could come from entrepreneur Robin Farmanfarmaian, who lost three organs unnecessarily to misdiagnosis, or Sarah Krüg, president of the Society for Participatory Medicine, whose parents died from diseases that might have been caught if the doctors had paid attention to their reported symptoms.

Or the testimony could come from Greg LaGana and Barry Levy, MDs who write and perform in a musical review called Damaged Care that skewers everything about doctors behavior as well as the legal and financial environment in which they have to operate.

Anna MCollister-Slipp, co-founder of Galileo Analytics and a sufferer from type 1 diabetes, regaled us with the dozens of vital sign measurements, treatments, and other details she has to manage on her own manually. She still get lab reports only because her doctor sends them via email (using a private account, so that HIPAA zealots don’t discipline him–the rights and wishes of the patient are supposed to be paramount). Like other conference attendees, though, she reported progress in tools and patient-oriented culture.

Less was heard at the symposium from other sectors of the medical field, but we did hear from Michael of Aetna, Jonathan Bush of athenahealth, and Beverley Bryant of England’s National Health Service. The panel on which Bryant spoke proved to be discouraging. Many of us in the US like to think that other developed nations with their universal health care systems have solved the coordination and interoperability messes that the US is in. But the panelists expressed many familiar frustrations.

I plan to return to the Connected Health Symposium next year, and I’m sure each year will bring a bit of progress toward better communication among staff, better use of patient data, and better integration of tools. The mood at the show was largely positive. But a little probing turned up barriers in the way of the healthcare system we all want.

Costs of Healthcare, Benefits of Healthcare IT and Health Tracking at #chs11

Posted on October 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Seems like people really liked my tweets from yesterday at the Connected Health Symposium. So, I thought I’d do it again today. Here’s some of the interesting tweets I saw and wrote during the Connected Health Symposium.


The cost of healthcare was a major theme throughout the entire conference. I agree completely that as patients start to pay more of their healthcare, they need more information and make better decisions.


I found this really interesting. Twitter (and even this blog) doesn’t quite capture the irony of the statement. Basically, Dr. Tippets from Verizon really highlights how if we did IT right in healthcare we have the potential of saving lives and live longer. Both noble goals.


I think Blumenthal might have actually said Healthcare IT instead of EHR, but there’s a lot of overlap in this. I agree with Blumenthal that the media and even blogs like mine love to write about the negative more than the positive. It makes for a compelling headline. Maybe the people behind the good research studies need to promote themselves more too.


This kind of hit me on multiple levels. First, I found it interesting that 15% are tracking their weight and exercise. Is that too low? It’s probably the highest level of any other healthcare data tracking app. I wonder where the rest of the apps stand. The second thing that hit me was the fact that doctors aren’t using this data. Finding some way to make it easy and useful for doctors to use all this collected information is going to be a challenging, but important next step. I’ll be interested to see how EHR companies work through the process of taking that data and integrating it into their EHR software. It won’t be easy, but I believe patients will love this type of integration. Plus, it would encourage many others to start using these medical devices.

Some Twitter Thoughts from the Connected Health Symposium

Posted on October 20, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m busy today and tomorrow at the Connected Health Symposium in Boston. It’s been a pretty interesting event. Instead of generally regurgitating facts, they’re bringing up topics which are new and interesting. You can follow my @techguy Twitter account for more updates or the #chs11 hashtag to read all the coverage.

Here’s a few of my tweets from today to give you an idea of some interesting thoughts from the event.

http://twitter.com/#!/techguy/status/127078090168991745

It’s Official – I’m Attending the Connected Health Symposium in Boston

Posted on September 22, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

UPDATE: I’m also going to be doing a healthcare IT event in Boston with ScratchMM if you’re not going to the conference and still want to come meet me. Just register for the event here so we know how many are coming.

I’ve finally finished the plans for my trip to Boston for the 2011 Connected Health Symposium that’s done by Partners Healthcare. The Connected Health Symposium is October 20-21, 2011. I think I’ll enjoy the event.

A quick look at the agenda and the people on the agenda illustrates why I’m excited to attend the event.

The organizers of the event also sent a discount code for $400 off the regular rate for all HealthcareScene.com readers. The coupon code is: HealthcareScene (all one word) and you can register here. Word is that you might even get a special HealthcareScene.com ribbon if you use that code to register.

I’ll have a bit of free time in Boston the day before the event and Thursday evening I may have a little meetup. So, if you’re close to Boston, I’d love to meet you in person and hear your story. It’s always great fun for me to meet the readers of my sites.

This Is Not An Ad For The Connected Health Conference, But Go Anyway, OK?

Posted on April 20, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

In October of this year, the very smart people at the Center for Connected Health in Boston will again hold their annual symposium.  And unless I get hit by a bus, I intend to be there and learn everything I can.

While you’ve seen me get flip here from time to time, I’m not joking now.  I think that it’s an event that should be taken dead seriously by essentially anyone who cares about the future of health IT, disease management and e-medicine.  Their mission, which I regard as central to the future of healthcare generally, is as follows:

We are engaging patients, providers and the connected health community to deliver quality care outside of traditional medical settings. Telehealth, remote care and disease management initiatives reflect the opportunities for technology-enabled care programs.

By the way, in case you suspect the same, I’m not endorsing the conference because the center is backed by Partners HealthCare, an IDS backed by hoity-toity names like Mass General Hospital and Brigham and Women’s.   Their Harvard connection isn’t the point.

No, I’m ranting about the Connected Health Symposium because I think it’s exactly where HIT visionaries ought to be spending their time.  Their programs are demonstrating, today, how the living, breathing HIT structure can bring care to where it’s needed in addition to documenting what happens in traditional settings.

There’s too much going on at the Center for me to provide a wealth of detail, but here’s some examples of what it does (summaries borrowed from media announcements):

*  Last summer, the CCH announced the results of a medication adherence study, using a wireless electronic pill bottle to remind patients with high blood pressure to take their medication. The ongoing study measured a 27% higher rate of medication adherence in
patients using Internet connected medication packaging and feedback services compared to controls.

* Another study found that remote online visits with dermatologists, or e-visits, achieved equivalent clinical outcomes for acne patients. Data further revealed that this model of care delivery was popular with participating doctors and patients, ranking e-visits as convenient and time-saving.

* Data from a late 2009 pilot  conducted by the Center suggested that its online diabetes management program, Diabetes Connected Health, may lead to improved patient knowledge, engagement and accountability, as well as improved patient provider communication.

Don’t get me wrong, the industry can’t avoid wrestling with EMR implementation and management efforts even if providers spend a lot more on remote patient monitoring and telemedicine.  Any reasonable long-term vision of a fully-connected U.S. digital health network includes all of these technologies, plus mobile health innovations we probably haven’t even heard of yet.

But in the mean time, c-health is where the rubber meets the road. (If you want to know what c-health is, read the blog written by the Center’s Dr. Joe Kvedar.)

Hoping to meet y’all in October!