Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

Patients Favor Tracking, Sharing Health Data

Posted on February 3, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

To date, I’d argue, clinicians have been divided as to how useful medical statistics are when they come straight from the patient. In fact, some physicians just don’t see the benefit of amateur readings. (For example, when I brought my own cardiologist three months of dutifully-logged blood pressure and pulse readings, she told me not to bother.)

Research suggests that my experience isn’t unique. One study, released mid-last year by market research firm MedPanel, found that only 15% of physicians were recommending wearables or health apps to patients as tools for growing healthier.

But a new study has found that patients side with health-tracking fans. According to a new study released by the Society for Participatory Medicine, 84% of respondents felt that sharing self-tracking stats such as blood glucose, blood pressure, heart rate and physical activity with their clinician would help them better manage their health. And 77% of respondents said that such stats were equally important to both themselves and their healthcare professional.

And growing numbers of healthcare professionals are getting on board. A separate study released last year by Research Now found that 86% of 500 medical professionals said mHealth apps gave them a clearer understanding of a patient’s medical condition, and 76% percent felt that apps were helping patients manage chronic illnesses.

Patients surveyed by the SPM, meanwhile, seemed downright enthusiastic about health trackers and mobile health:

* 76% of adults surveyed would use a clinically-accurate and easy-to-use personal monitoring device
* 57% of respondents would like to both use such a device and share the data generated with a professional
* 81% would be more likely to use a consumer health monitoring device if their healthcare professional recommended such a device

Realistically, medical pros aren’t likely to make robust use of patient-generated data unless that data can be integrated into a patient’s chart quickly and efficiently. Some brave clinicians may actually attempt to skim and mentally integrate data from a health app or wearable, but few have the time, others doubt the data’s accuracy and yet another subgroup simply finds the process too awkward to endure.

The bottom line, ultimately, seems to be that patient-generated data won’t find much favor until hospitals and medical practices roll out technologies like Apple’s HealthKit, which pull the data directly into an EMR and present it in a clinician-friendly manner. And some medical pros won’t even be satisfied with a good presentation; they’ll only take the data seriously if it was served up by an FDA-approved device.

Still, I personally love the idea of participatory medicine, and am happy to learn that health trackers and apps might help us get closer to this approach. As I see it, there’s no downside to having the patient and the clinician understand each other better.

Doctors, Not Patients, May Be Holding Back mHealth Adoption

Posted on June 24, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Clearly, mHealth technology has achieved impressive momentum among a certain breed of health-conscious, self-monitoring consumer. Still, aside from wearable health bands, few mHealth technologies or apps have achieved a critical level of adoption.

The reason for this, according to a new survey, may lie in doctors’ attitudes toward these tools. According to the study, by market research firm MedPanel, only 15% of physicians are suggesting wearables or health apps as approaches for growing healthier.

It’s not that the tools themselves aren’t useful. According to a separate study by Research Now summarized by HealthData Management, 86% of 500 medical professionals said mHealth apps gave them a better understanding of a patient’s medical condition, and 76% said that they felt that apps were helping patients manage chronic illnesses. Also, HDM reported that 46% believed that apps could make patient transitions from hospital to home care simpler.

While doctors could do more to promote the use of mHealth technology — and patients might benefit if they did — the onus is not completely on doctors. MedPanel president Jason LaBonte told HDM that vendors are positioning wearables and apps as “a fad” by seeing them as solely consumer-driven markets. (Not only does this turn doctors off, it also makes it less likely that consumers would think of asking their doctor about mHealth tool usage, I’d submit.)

But doctors aren’t just concerned about mHealth’s image. They also aren’t satisfied with current products, though that would change rapidly if there were a way to integrate mobile health data into EMR platforms directly. Sure, platforms like HealthKit exist, but it seems like doctors want something more immediate and simple.

Doctors also told MedPanel that mHealth devices need to be easier to use and generate data that has greater use in clinical practice.  Moreover, physicians wanted to see these products generate data that could help them meet practice manager and payer requirements, something that few if any of the current roster of mHealth tools can do (to my knowledge).

When it comes to physician awareness of specific products, only a few seem to have stood out from the crowd. MedPanel found that while 82% of doctors surveyed were aware of the Apple Watch, even more were familiar with Fitbit.

Meanwhile, the Microsoft Band scored highest of all wearables for satisfaction with ease of use and generating useful data. Given the fluid state of physicians’ loyalties in this area, Microsoft may not be able to maintain its lead, but it is interesting that it won out this time over usability champ Apple.

Annual Evaluation of Health IT: Are We Stuck in a Holding Pattern? (Part 3 of 3)

Posted on April 15, 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 installments of this article covered major regulatory initiatives and standards projects. Some of the same questions have a direct impact on technological advances.

Medical Devices: Always With You, But Neither Here Nor There

One ad I saw compares a fitness device to a friend whispering in your ear wherever you go. Leaving aside control freak issues, what could be better for a modern patient with a condition that responds to behavior change than a personal device? Through such devices, we can implement a 24/7 cycle of medical care. We can also save enormous sums of money by treating the patient in his natural environment instead of a hospital or rehab facility.

The rapid spread of health devices was a foregone conclusion even before Apple thrust it into the mainstream with HealthKit. Last month’s launch of ResearchKit suggests that Apple will do the same for the big data revolution in health care championed by the Personal Genome Project, 23andMe (now back in the business after being reined in by the FDA), PatientsLikeMe, and other pioneer organizations. Apple Watch, an indulgence expected to grab the hearts of the affluent, might pull off the paradigm shift in how we interact digitally that Google Glass aimed at.

For these devices to make the leap from digital pets to real medical intervention, including a strengthening of the bond between clinicians and patients, they must satisfy stringent requirements for safety and accuracy. Current FDA regulations distinguish (in very rough terms–I am not a lawyer) between devices that make diagnoses or recommend treatments and other devices that merely measure vital signs or deliver reminders. If you make a diagnosis or recommend a treatment, you need to undergo a complex and expensive evaluation. People can also submit problems they find about your device to FDA’s medical device database.

Safety, accuracy, and transparency are goals well worth pursuing. The problem is not the cost of certification techniques, but the vast gulf between the development model assumed by certification and the one followed by modern developers of both software and hardware.

Development methods nowadays are agile. Developers incrementally release versions of software or hardware and upgrade them every few months. But certification processes require retesting every time the smallest change is made. And that’s reasonble because any tweak (even a configuration change out in the field) can cause a working device to fail. Such certifications work well for embedded systems in airplanes and nuclear facilities, and even critical medical devices that may live in patients’ bodies for decades. But they slow innovation to a crawl and raise prices precipitously.

Oddly enough, the tension between agile development and certification affects medical devices and electronic health records (EHRs) equally, and EHRs are equally prone to errors or misleading interfaces. Yet medical devices are regulated while EHRs are not. This contradiction must be resolved–but perhaps not by dropping the anvil of safety certification on all software used in medicine. The FDA can search for a more supple regulatory process that blesses certain classes of hardware and software while allowing for variation within them, backed up by guidelines for robust development and testing.

The FDA understands that it’s in an untenable situation but doesn’t know what to do. They have shaved off certain devices and marked them for lower levels of scrutiny, such as devices that transfer or display data collected elsewhere. The FDA has also led a muddled discussion over a national “test bed” for medical devices. More regulatory clarity in the area of both devices and EHRs, along with a push by regulators and users for better development practices, could help the field take off and realize the promise of personal devices.

Conclusion

I’m excited about the possibilities of health IT, but concerned that the current environment is insufficiently friendly for its deployment. On top of all the other factors I’ve cited that hold back the field, consider the urgent shortage of health IT staff. Providers and development firms have been bidding up salaries to steal each other’s employees, and attempts to increase the pool have shown disappointing results.

What I hear is that IT experts would love to get into health care, knowing that it can help the public immensely as well as pay off financially. But they have balked at the technical and working conditions in the field: hide-bound institutions, 50-year-old standards and tools, and of course the weight of standards and regulations to study.

How many of these topics will be covered at HIMSS? FHIR will be widely considered, I know, and the buzz over Meaningful Use is always strong. The question what will prod change in the system. Ultimately, it may come from a combination of consumer demand and regulatory pressure. Progress for the sake of progress has not been a prominent trait of health IT.

The Future of Health Involves Human-Agent Collectives (Part 1 of 2)

Posted on February 2, 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.

Everyone understands that isolated interventions in the doctor’s office will not solve the chronic health conditions that plague developed nations and inflate health care costs. So as the health field shyly tries on new collaborative styles–including coordinated care, patient-centered medical homes, and accountable care organizations–participants are learning that the supporting technologies must also enable collaboration in ways vastly more sophisticated than current EHRs and devices.
Read more..

By Supporting Digital Health, EMRs To Create Collective Savings of $78B Over Next Five Years

Posted on December 1, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Here’s the news EMR proponents have been insisting would emerge someday, justifying their long-suffering faith in the value of such systems.  A new study from Juniper Research has concluded that EMRs will save $78 billion cumulatively across the globe over the next five years, largely by connecting digital health technologies together.

While I’m tempted to get cynical about this — my poor heart has been broken by so many unsupportable or conflicting claims regarding EMR savings over the years — I think the study definitely bears examination. If digital health technologies like smart watches, fitness trackers, sensor-laden clothing, smart mobile health apps, remote monitoring and telemedicine share a common backbone that serves clinicians, the study’s conclusions look reasonable on first glance.

According to Juniper, the growth of ACOs is pushing providers to think on a population health level and that, in turn, is propelling them to adopt digital health tech.  And it’s not just top healthcare leaders that are getting excited about digital health. Juniper found that over the last 18 months, healthcare workers have become significantly more engaged in digital healthcare.

But how will providers come to grips with the floods of data generated by these emerging technologies? Why, EMRs will do the job. “Advanced EHRs will provide the ‘glue’ to bring together the devices, stakeholders and medical records in the future connected healthcare environment,” according to Juniper report author Anthony Cox.

But it’s important to note that at present, EMRs aren’t likely to have the capacity sort out the growing flood of connected health data on their own. Instead, it appears that healthcare providers will have to rely on data intermediary platforms like Apple’s HealthKit, Samsung’s SAMI (Samsung Architecture for Multimodal Interactions) and Microsoft Health. In reality, it’s platforms like these, not EMRs, that are truly serving as the glue for far-flung digital health data.

I guess what I’m trying to say is that on reflection, my cynical take on the study is somewhat justified. While they’ll play a very important role, I believe that it’s disingenuous to suggest that EMRs themselves will create huge healthcare savings.

Sure, EMRs are ultimately where the buck stops, and unless digital health data can be consumed by doctors at an EMR console, they’re unlikely to use it. But even though using EMRs as the backbone for digital health collection and population health management sounds peachy, the truth is that EMR vendors are nowhere near ready to offer robust support for these efforts.

Yes, I believe that the combination of EMRs and digital health data will prove to be very powerful over time. And I also believe that platforms like HealthKit will help us get there. I even believe that the huge savings projected by Juniper is possible. I just think getting there will be a lot more awkward than the study makes it sound.

Microsoft Joins Battle for Wearables Market

Posted on November 4, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Following the lead of several other companies big and small, Microsoft has jumped into the wearables healthcare market with a watch, a fitness tracker and a cloud-based platform that condenses and shares data.

It’s little wonder. After a few years of uncertainty, it seems pretty clear that the wearables market is taking off like a rocket. In fact, 21% of US consumers own such a device, according to research by PricewaterhouseCoopers. That’s slightly higher that the number of consumers who bought tablets during the first two years after they launched, PwC reports. Not only Microsoft, but Apple and Samsung, as well as smaller players with a high profile — such as Fitbit — are poised to take the sector by storm.

Microsoft’s new entry is called Microsoft Health, a platform letting users store health and fitness data. The date in question is collected by a Microsoft Health app, available on Android, iOS and Windows Phone. The platform also gathers data generated from the Microsoft Band, a smart and designed to work with Microsoft’s new platform.

The idea behind pulling all of this data into a single platform is to integrate data from different devices and services in a smart way that allows consumers to generate insights into their health. The next step for Microsoft Health, execs say, is to connect all of that data in the platform to the tech giant’s HealthVault, a Web-based PHR, making it easier for people to share data with their healthcare providers.

Other tech giants are making their own wearables plays, of course. Google, for example, has released Google Fit, a fitness-based app designed to help users track physical activity. Google’s approach is  Android smart phones, relying on sensors built into the smart phones to detect if the user is walking, running or biking. Users can also connect to devices and apps like Noom Coach and Withings.

Apple, for its part, has launched HealthKit, its competing platform for collecting data from various health and fitness apps.  The data can then be accessed easily by Apple users through the company’s Health app (which comes installed on the iPhone 6.) HealthKit is designed to send data directly to hospital and doctor charts as well. It also plans to launch a smart watch early next year.

While there’s little doubt consumers are interested in the wearables themselves, it’s still not clear how enthusiastic they are about pulling all of their activity onto a single platform. Providers might be more excited about taming this gusher of data, which has proved pretty intimidating to doctors already overwhelmed with standard EMR information, but it remains to be seen whether they’ll find fitness information to be helpful.

All told, it looks like there will be a rollicking battle for the hearts and minds of wearables consumers, as well as the loyalty of providers.  As for me, I think it will be a year or two, at minimum, before we get a real sense of what consumers and providers really want from these devices.