Beyond Medical Informatics

This article, ONC releases five-year strategic health IT plan, provides some goals to get a National Health IT plan started. The goals include:

• Achieve adoption and information exchange through meaningful use of health IT
• Improve care, population health and reduce healthcare costs through the use of health IT
• Inspire confidence and trust in health IT
• Empower individuals with health IT to improve their health and the healthcare system
• Achieve rapid learning and technological advancement

These goals are definitely something we can use in the Philippines. I think the ICT4Health efforts have similar goals.

The best next step is to formulate an action plan for each goal.

On a more personal note, these goals are not "confined" to the national level. With their broad practical application, even hospitals and other organizations can adopt these goals.

Seems like my 5-year strategic Health IT plan for The Medical City is off to a good start.

This Medscape article identifies 10 "exciting and important new tools" that will someday be "changing the practice of medicine." They are:

1. Video Consults on Your Smartphone
2. Tablet Computers
3. Speech Recognition Programs
4. Handheld Ultrasound Stethoscope
5. Smart Bandage
6. Unified Communications
7. Remote Medical Devices and Functions via Smartphone
8. Automated Medication Adherence
9. Electronic Reference Tools and Calculators
10. Social Networking

I especially like 1 (Video consults on your smartphone) and 10 (social networking). Some are old technologies getting new uses in healthcare, while others are emerging technologies.

I don’t completely agree with the article as I have to see whether the emerging technologies will prove value in patient care processes but the list shows great promise.

Here’s a great idea we can use in healthcare applications:

Advanced sign-in security for your Google account

… we’ve developed an advanced opt-in security feature called 2-step verification that makes your Google Account significantly more secure by helping to verify that you’re the real owner of your account. Now it’s time to offer the same advanced protection to all of our users.

2-step verification requires two independent factors for authentication, much like you might see on your banking website: your password, plus a code obtained using your phone.

Imagine using security methods like these for clinical applications over the Web, e.g. PHRs and hospital EMRs. Patients can feel secure about their access to their Personal Health Records (PHR). Doctors can work with the hospital EMR from home.

Another good use would be for hospitals or patients giving access to other doctors.

I think this should be easy to emulate here in the Philippines with our advanced SMS technology.

I think this news is worth looking into here in the Philippines: Telemedicine at the eICU – The Journal-Standard via HealthLeaders Media

The new program is part of the telemedicine specialty, and is a collaboration with the University of Wisconsin e-Care in Madison, Wis. This allows for highly skilled care with a team of “intensivists,” who are physicians with advanced critical care board certification that specialize in treating the most seriously ill or injured patients.

…

This specialty care has been used at FHN since Aug. 11. The eICU care is where small microphones and cameras in each ICU patient room provide a constant link to the e-Care team at UW Hospital, which includes some of the nation’s top respected intensivists. Each ICU patient’s vital information, such as heart rate, blood pressure, medications and test results, are monitored in the FHN ICU and shared in real time with the e-Care team.

If a patient’s condition changes rapidly or unexpectedly and requires a medical response, the FHN physician and nurses at the patient’s bedside can touch a button and activate a two-way visual and audio link for consultation with e-Care specialists.

Although I work in Manila, I live in Pangasinan and my parents live in Zamboanga. I’ve seen the ICU’s of the best hospitals in these provinces. Although they do their best with what they have, access to the right clinical expertise can make a lot of difference for the patients admitted for critical care.

I like this idea very much. I’ll keep this idea on hand and see if I can interest some groups to start initial research and collaboration.

Related articles by Zemanta

• Telemedicine Helps Doctors Connect With Faraway Patients (itexpertvoice.com)
• Cogent Healthcare Launches New Intensivist Service Line (eon.businesswire.com)

Here’s an interesting article: Physician studying diagnoses from phone-generated photos – FierceMobileHealthcare.

In Tuesday’s edition, the Post features George Washington University emergency physician Dr. Neal Sikka, who, according to the story, has been using camera phones to help diagnose minor wounds for friends and family pretty much since he became a physician in 1999. (Did we really have camera phones back then?)

Now, Sikka is in the midst of a six-month study at GWU Hospital of the accuracy of diagnoses from phone-generated photos sent by patients. He calls this the largest mobile health study of acute wound care to date.

For the study, patients snap photos of their own injuries and send them to a secure email account at the hospital. They also fill out a medical history form. “We’ll look at their picture along with the questionnaire and make a diagnosis,” Sikka tells the Post. Study researchers–ED physicians and  physician assistants–then look at the photos on a computer and make a diagnosis. Another physician then will physically examine the patient to test the accuracy of the diagnosis by cell phone.

The original story is from The Washington Post.

In 2006, I was involved in a project started by Dr. Paul Fontelo, my NLM mentor. It was called MMSPix and was presented in AMIA 2007. It involved using MMS, camera phones and an online repository for submitted images.

Abstract:

Smartphones with cameras have added a new dimension to augmenting medical image collections for education and teleconsultation. It allows healthcare personnel to instantly capture and send images through the multimedia messaging service (MMS) protocol. We developed a searchable archive, a mobile images Weblog of camera phone images for medical education. Registered users can view and comment on uploaded images. The archive is compartmentalized to allow sharing images with all viewers and by clinical specialty groups.

Many Filipino doctors already use SMS/text messaging as one of their communication channels with patients. And I’m sure there are already groups in the Philippines doing similar trials and studies with phone-captured images. With the right infrastructure, application and safeguards, we can find ways to maximize the ubiquity of camera phones in the country and make teleconsultations work to improve care.

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Are you currently using SMS or MMS in your practice? Do you have an ongoing study, trial or implementation using camera phones? I’d like to hear about them.

Singapore moves forward with their National EHR Project.

Singapore Awards US$144M EHR Contract

A consortium made up by Accenture, Oracle, and Orion Health has won Singapore’s National Electronic Health Record project, a credible source has told FutureGov.

…

The National EHR project aims to connect all the EMRs in Singapore and achieve the “one patient, one record” vision.

Healthcare IT professionals all over the Asia-Pacific region should watch the progress of this project closely. I know I will. I can only hope we can start something similar in the Philippines.

The growing popularity of iPad is a boon for other touchscreen or tablet devices. These devices hold great potential for better mobility and portability in clinical settings.

Competing models from China and Taiwan should drive prices down in the Asian marketplace. Hopefully, this translates to penetration and adoption of these technologies.

Other articles about iPad alternatives:

• iPad Alternatives: The Main Contenders
• iPad alternatives
• Top 10 iPad Alternatives
• Seven alternatives to the Apple iPad
• Seven more iPad alternatives

Mobile healthcare has been waiting for this kind of technology to proliferate. I can’t wait to get my hands on any of them to test them out.

I recently stumbled upon good news about CHITS:

First Region-wide CHITS-EMR Conference a Success

CHITS stands for Community Health Information Tracking System. More info about it here.

Here’s a ‘HIT’ idea for TV: New York hospital transforms TV into care tool | Healthcare IT News

Automated patient education is an integral component of the new service, said hospital executives, and nurses will be able to order education programs specific to each patient and track its completion all from their existing electronic health record system.

Here’s the ‘money shot’. The new service will:

…turn the hospital’s in-room televisions into tools for clinical teaching and entertainment.

The idea is not new, I know, but I’ve heard of so few similar implementations that a ‘re-run’ of the concept is timely.

Now, this is what I call ‘Better TV’!

(Ok, ok. I apologize for all the TV slang. I just can’t help it.)

I got this through the Philippine Medical Informatics Society (PMIS) mailing list—a new online Wikibook entitled ‘Handbook of Biomedical Informatics’.

http://en.wikipedia.org/wiki/Book:Biomedicalnformatics

The sender was Instituto Edumed. Here’s an excerpt of the email.:

In another striking innovation in the world of electronic publications  and Web 2.0, the online encyclopedia Wikipedia, in its English version,  has published today a new online Wikibook entitled "Handbook of  Biomedical Informatics", version 1.0, after more than 5 months of  organization work. The book is based on articles published on the  subject by Wikipedia.

The book has 276 pages in its PDF version, and gathers, organizes and  classifies all the knowledge amassed by the Wikipedia articles on topics  in health informatics, telehealth, standards and classifications in  health informatics, and related topics, organized into 21 sections and  more than 250 entries. Thus, it is considered one of the most  comprehensive and complete books in the area.

Head on to the site and see for yourself!

I will give a review or update once I’ve time to run through the contents.

Just a quick observation: In the Wikipedia link, is it really Biomedicalnformatics? In all caps, this is how the namespace would look: BIOMEDICALNFORMATICS. There’s no I in Informatics.