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“You can’t list your iPhone as your primary-care physician.”

Posted on June 2, 2015 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.

iPhone as Primary Care Physician
“You can’t list your iPhone as your primary-care physician.”

This cartoon and more importantly the phrase below it has been going around a bunch on social media lately. I’m sure it makes the majority of doctors roll their eyes and get a little bit angry. Their immediate response is likely “Are you trying to say that my 15 years of school can be replaced by a smart phone?”

I think this question misses the point of the humor. Remember that it’s a cartoon and so it’s meant to be exaggerated. Let me clear the air though. I don’t think any smart phone or even technology is going to completely replace the human element of healthcare. I’m even someone that believes that love and affection can be shared using technology (I’ve seen it and experienced it), but technology can’t replace the human interaction completely. I’ve yet to see a gall bladder removed using a smart phone.

Yes, we’ll need doctors. However, that doesn’t hide the point of the cartoon, which is to highlight the ever increasing influence that our mobile phone will have over our healthcare. You can hide your head in the sand and act like it’s not happening if you want, but that doesn’t change the reality of how the smart phone is going to change healthcare as we know it. In many ways, it already is.

Android’s Advantage Over iPhone in Mobile Health Applications

Posted on February 7, 2013 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.

The reports are all over the web comparing the Android market share to iPhone’s market share (see one example here). These numbers are important for anyone in the mobile health space that’s considering their strategy for developing a mobile health application. The same goes for EHR vendors that are working on their mobile EHR strategy.

The reality as I see the mobile phone market share numbers is that Android is taking the lead when it comes to market share. No doubt, iPhone still has an incredibly compelling offering and many loyal fans. This is particularly true in healthcare where a doctor having an iPhone is in many ways a bit of a cool “status” symbol for the doctor. However, in the long term I think that even healthcare will see a similar market share shift to the Android over the iPhone as well.

Why am I so bullish on the Android in healthcare despite healthcare’s current love affair with the iPhone?

The core reason that I think the Android phones (and much of this could apply to tablets as well) will do very well as mobile health applications is because of how much customization is possible with Android devices. In fact, pretty much anything is possible on an Android phone because of the open source nature of the software. I expect many mobile health applications will need and want to exploit the flexibility and openness of Android over the iPhone.

One concern I do have about this idea is that Android does pose its own challenges for developers. In the case of the iPhone, you basically only have to code your application to work across a small handful of iOS versions and handsets. In fact, Apple has smartly made sure that many things remained the same across every iPhone. This makes developers lives much easier. In the case of Android, you have hundreds of possible handset combinations you have to consider when developing your application. This can be really hard to test and can often lead to a bad user experience for some Android devices.

In some ways, the current Android environment reminds me of the challenges we use to face (and still do today in some ways) in creating a webpage that worked across all the various web browsers. A lot of effort went into making sure your website worked everywhere. However, over time the standards have developed and this is much less of an issue today than it was when the internet first started. I believe the same will be true for Android.

The reality is that Android and iPhones are both here to stay for the foreseeable future. Most mobile health applications are going to have to be able to support both platforms. Some might say that we should just be glad that it’s only two platforms we have to worry about. We had a lot more than two to think about back during the internet browser wars.

Glucose Meter to iPhone

Posted on February 13, 2012 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.

A few weeks ago Techcrunch announced the $3.5 million in funding that Glooko received to connect Glucose meters to iPhones for tracking diabetes. Here’s a description of Glooko:

Launched last year, Glooko is a digital logbook for people with diabetes who have to check their blood sugar every day. There are dozens of glucose logbooks in iTunes, but almost all of them require manual entry. What makes Glooko different is that the company designed a $40 cable (sold separately) that works with seven of the top glucose meters. You just plug it into both devices and it downloads your daily readings.

This is an interesting approach because it allows someone to use the Glucose meter that they’re use to using all of the time. Although, I don’t know many people that want to carry around a glucose meter with their phone and a cable to connect the two. I’m sure that Glooko would argue that the problem is that the glucose meters don’t support a wireless (bluetooth or NFC I suppose) technology for the exchange of that data. They’re right that it is a limitation of the traditional glucose meters.

The solution is to go down the path that AgaMatrix has gone down with their blood glucose meter that attaches to the iPhone. Basically it makes your blood glucose meter the size of a thumb drive. If you don’t want to carry your phone, you can just carry the small meter and some strips (yep, I don’t know if we’ll ever get away from the strips). Then, when you hook the meter back up to your iPhone it uploads all the data. Or, just leave it attached to your phone since it’s not that big.

I’ll be interested to see how well Glooko does with their $3.5 million in investment. There’s a lot of people focusing on the diabetes market.

Just What the Doctor Ordered: Mobile Access to Your Kaiser EHR

Posted on January 26, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Recent news that Kaiser Permanente has made its patients’ electronic health records available via mobile devices comes as no surprise. Kaiser often seems to be at the forefront of interoperability and coordinated care, in large part due to its integrated nature and sheer volume of patients. As the company’s press release mentions, it maintains the “largest electronic medical records system in the world.” Now, 9 million of its patients can view their EHRs via a mobile site or Android app, with an iPhone app expected to launch in the near future.

On a macro level, I think this is a great step towards further empowering patients to take control of their health. By giving 9 million folks instant access to their own health information, I’d like to think that this will in turn prompt their friends and relations to ask, “Why doesn’t my doctor do that? What benefits am I missing out on?” And perhaps these same folks will then have a conversation with their provider about adopting this type of mobile access.

I’d be interested to see six months to a year from now, statistics comparing use of the mobile app/site to use of the tools found on the traditional website. Will Kaiser see a tremendous increase in the amount of emails between doctors and patients via its mobile apps? Are its doctors prepared for the potential onslaught of correspondence? I wonder if a few have balked at the possibility of being overrun by emails from particularly communicative patients.

Will they be able to tie these usage statistics to a jump in quality outcomes? Will mobile access ultimately become a criteria measured within accountable care models or patient-centered medical homes? Will mobile health truly equal better health?

On a micro level, I would certainly appreciate the effectiveness of access like this, which includes the ability to view lab results, diagnostic information, order prescription refills and the aforementioned email access to doctors. I can’t tell you how many times I’ve been on the phone with a pediatric advice nurse and drawn a blank when asked what my child’s current weight might be. It would be nice to be able to quickly pull that data up on my cell phone, especially while we’re on the go or out of town. I could eventually see patient charting apps being layered on top of this, so that in the event of a high, overnight fever, I could log temperatures via the mobile app and review them with our pediatrician – possibly alerted every time a new temp or symptom is entered – the next morning.

The possibilities seem endless. I think the big goal for Kaiser now is to get folks engaged and using these new access points.

Medical Siri on the iPhone and iPad

Posted on November 11, 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.

One of my regular physician readers, Brian, left the following comment on my post about the mythology of the Perfect EMR.

The reality is that we are now comparing EMR to our iPhone 4s’s. Our consumer technology is so far ahead of hospital technology that it is jarring and annoying to use work tech. This is what I want: “Siri, give me a differential for elevated amylase. Thank you. Now order CBC, Chem 14, TSH and free T4. Good. Now I will dictate. The patient is a 41 year old man with abdominal pain…”

Certainly we could have a long discussion about the difference in consumer technology and popular healthcare technology. However, I couldn’t help but wonder how many doctors have tried out Siri on their iPhone in order to get healthcare information. I bet this is pretty common. Although, I wonder how good the answers are that Siri gives.

If you’re a medical provider that’s used Siri for accessing health and medical information, I’d love to hear about your experience. I bet there are probably also a bunch of funny experiences trying to use Siri for medical info. I’d love to hear those as well.

Are there ways that “Siri” like technology could and should be implemented in EMR and EHR software?

EMR in the Age of Skype

Posted on September 12, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

The physician community has something of a split persona. Doctors are probably the only community still dedicated to using pagers to communicate with their offices. And yet, it’s no secret that the medical establishment is among the fastest growing segment among smartphone and tablet users. A widely quoted statistic from Manhattan Research stated that 81 percent of doctors would own a smartphone. Manhattan now states that the 81 percent rate has already been reached in 2011, while average America is at 40 percent adoption, according to Nielsen.

So, the medical establishment is clearly ahead of the curve in some ways.

But you just have to juxtapose pagers and smartphones against each other to understand the real advantages of the smartphone. If you have an iPhone and your doctor has one too, you’re going to probably take it to the next level, right? Yeah, FaceTime. (Surprisingly enough, that’s not what the statistics show. A full 78 percent of respondents said they didn’t want to chat or IM with their doctors, according to this recent article on Technology Review.)

For this kind of face to face interaction to work, it really depends on how good a rapport you have with your doctor, but if there’s a good doctor-patient relationship, you might just consider making the move. Let’s be clear, doctors are not taking to video-conferencing via Skype or Face-Time in droves (or rather, there are no published statistics from the bean-counting firms about the trend), but there are some anecdotal stories on blogs like Dr. Brian Goldman’s on CBC.ca. But it’s interesting to think ahead to how video consultations might change EMR.

The Pros:
Direct connection with your doctor, in an instant: Great for the patient, furthers doctor-patient relationship but could be something of a double-edged sword.
Show, don’t tell: For those times, when you don’t know whether a symptom needs an in-office visit, or when you’re not in town and some conference magic and ePrescribing can save the day.
No more Lost in Translation: The paging process has that additional office staff layer in between, who convey your message to the doctor. It’s tempting to think that you can axe the middleman with Skype.

The Cons:
Direct connection with your doctor, in an instant: How long before patients are calling at all hours of the night demanding FaceTime? Blackberries and iPhones might simply be another way to tether yourself to your business (Next time you see 24-7 IT support, know that there is a person dreading the Blackberry ping somewhere in the world)
Too many interruptions spoil the day: Pagers let the doc put off calling till she’s done with the task at hand, not when the patient demands.
Privacy issues: From an EMR perspective, this is the big kahuna. There are several nuances to consider. The doctor-patient line has to be securely done, with HIPAA in mind. For CYA purposes, video-cons will probably need to be recorded.

Microsoft’s main intent behind its purchase of Skype might be its conferencing features for business, but wouldn’t it be awesome if Skype also showed up in HealthVault (which only has image saving capabilities so far, according to this Q&A on MSDN forums)? Or if any advice dispensed via Skype could be saved into your doc’s EMR system and become part of your health profile. There are several possibilities out there when you throw video into the mix, and they seem quite interesting.

Mobile Makes the Difference in Emergencies … or on Vacation

Posted on August 3, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

My family and I have escaped this week to our favorite vacation destination, Pensacola Beach. And so I sit here writing in the cozy confines of the condo that we call home for close to a week nearly every summer. I gave barely a thought to how I was going to transmit this blog to the HealthcareScene.com servers while here. As it turns out, there is no WiFi, which means I’m relying on my iPhone to do a bit of online research, my laptop for Word, and the hotel across the street’s business center with which to cobble it all together.

My connectivity issues pale, of course, in comparison to those of providers working outside of their hospital’s four walls – be it in emergency situations such as the aftermath of a hurricanes like Ivan and Dennis, which hit Pensacola back in 2004 and 2005, respectively, or as part of a routine provider/patient encounter in telehealth programs. I wonder how providers at Pensacola’s Sacred Heart Hospital, where I was born (and no, I’m not telling you what year), handled patient care in the aftermath of Ivan, which devastated the town and outlying beach communities, and how mobile health solutions might better enable them should Mother Nature pay the same sort of visit today.

Well timed for this blog was the recent news that Epocrates has released the first phase of its EHR system, including an iPhone app, targeted to primary care practices with 10 physicians or less. The EHR, according to a recent report at MobiHealthNews.com, “is initially available as a Web-based SaaS product, includes patient encounter notes, electronic lab integration, e-prescribing and Epocrates’ flagship drug database.”

The iPhone version should be available in a few weeks, and is likely to include remote patient record look-up and schedule access, and e-prescribing. The iPad version, which is in development, will focus on point-of-care data capture. MobiHealthNews.com also reports that an Android app is in the works, but will be rolled out in later versions of the EHR.

It will be interesting to see if later versions also target larger physician practices, which would surely also benefit from mobile technology like this. Perhaps most interesting, at least to providers in places like Pensacola that see their fair share of hurricane-induced on-site emergency care, is that the Epocrates mobile EHR app will “be a native app and it will store patient data on the device,” according to the company, which means that “the device will not need a signal to access the EHR. Any new data will be synched with the record once the phone finds a signal.”

Hopefully that signal will not be as elusive in a community’s time of need as the WiFi seems to be at my vacation destination.

Using PIMSY EMR on an iPad and Android Device

Posted on May 30, 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.

One of the regular EMR and EHR readers, Judy, recently took up the challenge I posed in my previous post about Every EMR Vendor available on the iPad. She downloaded the LogMeIn Ignition app that I mentioned in that post and tried out her PIMSY EMR software on it. Thanks to Judy for sharing her experience.

The following is her experience and review.

I tested the new LogMeIn app to see if I could access PIMSY EMR from my older Droid and from an iPad. It takes a little getting used to: you have to familiarize yourself with how to navigate on the screen and how to change the size to get the screen view that works for you. Once you get that done you are good to go. That said, there are 2 ways to change the size: a magnifying option at the bottom of the screen or a zoom in bar on the right hand side; you can enlarge as much as needed. There are also 2 options for moving around: you can move the screen with your finger (the cursor stays put) or you can move the cursor like a regular mouse; I prefer navigating around the cursor. Both options make it simple to maneuver.

If you’re used to texting and typing on a smaller keyboard, it will be easier to adjust. The app itself gives you a keyboard that takes up approximately half the size of the screen, so larger phone screens like Droid 2 or iPhone would have a bigger keyboard than a regular Droid, and the iPhone keyboard was comparable to a regular size. For those who aren’t used to navigating and typing on a phone screen, there will be an adjustment period. If you’re connected to dual monitors, you can easily switch to either one, and I was able to watch a video.

The speed is slightly slower from phone or iPad to computer but very good from computer to computer. The app is not offered on a Blackberry. I would highly recommend this app to anyone who wants to connect to their desktop remotely; it worked great to get into PIMSY. Well worth $29.99.

Want People To Use PHRs? Try Making Them A Game

Posted on April 25, 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.

I’m embarrassed to admit this, but over the last week I’ve become addicted to a hideously cute little iPhone app called Shopkick.  The app locates where you are geographically, spits out a list of retailers for you, and when you click on the retailer’s name, typically rewards you with “kickbucks.”

The more kickbucks you get, the higher “level” you’re at, whatever that means — and when you collect, say, thousands of points you can get a $25 gift card. (Yippee!)  In truth, the rewards Shopkick offers probably average out to about 3 cents an hour. Who cares?  I keep playing with the stupid app until I’m out of offers to click.

Now can anyone tell me why the same type of scheme wouldn’t motivate at least some consumers to add data to their PHR on a regular basis?  Small cash rewards are already proving effective at improving medication compliance, after all, and for most people, updating their PHR would be no harder than taking a pill.

In the past, I’ve scoffed mightily at online schemes which reward people for participating in communities, filling out forms or otherwise doing what they’re told.  After all, why should anyone care if a site names them an “explorer” or a “champion” or a “grand poobah”?  But there I am, getting psyched when Shopkick promotes me from level 3 to level 4.  Hey, I can’t help it — every time you level up you get such a cute little chime and a big green bubble to pop…  (Yes, I am otherwise a mature, responsible adult.)

But I’m being taught, by playing with this app, that rewarding people — even with very small incentives — can do an amazing job of getting them to repeat behavior.  Offer patients relevant reinforcement and patients are likely to take the PHR maintenance job more seriously.   What if, for example, a health plan teamed up with a pharmacy retailer to offer discounts on products if patients maintained their data? It could be huge.

But don’t make the rewards too exciting. Hey, you might have to keep releasing new, updated versions of your gaming system to satisfy fans.