Beyond Medical Informatics

Here’s 2 bits of news about texting in healthcare:

Text4baby receives high grades

Surveyed participants in text4baby, a health information text messaging service for pregnant women and mothers of newborn infants, reported high levels of user satisfaction, according to researchers from the University of California San Diego (UCSD) and the National Latino Research Center (NLRC).

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Additionally, 63 percent of respondents reported that text4baby reminded them of an appointment or the need for an immunization; 75 percent reported that text4baby informed them of medical warning signs that they’d been unaware of; and 71 percent reported speaking to a physician about a topic they learned of through text4baby.

This is great use of texting for consumer health IT purposes. The text4baby site is here.

However…

Joint Commission- Doc ordering via text is unacceptable

Here’s the original post at the Joint Commission site.

Is it acceptable for physicians and licensed independent practitioners (and other practitioners allowed to write orders) to text orders for patients to the hospital or other healthcare setting?

No it is not acceptable for physicians or licensed independent practitioners to text orders for patients to the hospital or other healthcare setting. This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record.

I know this practice is somewhat common here in the Philippines.

What do you think?

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 the juicy news:

The stethoscope – medical icon, lifesaver and doctor’s best friend – is disappearing from hospitals across the world as physicians increasingly use their smartphones to monitor patients’ heartbeats.

More than 3 million people have downloaded a 59p application – invented by Peter Bentley, a researcher from University College London – which turns an Apple iPhone into a stethoscope.

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Bentleys iStethoscope application is not the only mobile phone programme lightening doctors bags and transforming their practices: there are nearly 6,000 applications related to health in the Apple App Store. The uptake has been rapid. In late 2009, two-thirds of doctors and 42% of the public were using smartphones – in effect inexpensive handheld computers – for personal and professional reasons. More than 80% of doctors said they expected to own a smartphone by 2012.The trend looks likely to gain pace as younger doctors enter the workplace. Some medical schools issue students with smartphones. In America, Georgetown University, the University of Louisville and Ohio State University are among those requiring undergraduates to use one.

via iPhone set to replace the stethoscope | Technology | The Guardian.

So, will the iPhone replace stethoscopes? I don’t think so.

No doubt it is still a cool technology but this is all hype, at this point. The steth has more uses than just hearing heartbeats. In extreme cases, it can even serve as a reflex hammer.

Now, smartphones are a different matter–and it is already making a difference. A recent article reports that mobile devices help in decision making.

Studying the positive trends in mobile healthcare is important, but sometimes the hype can get in the way.

Here’s a list of news, links and articles about Medical Informatics, Healthcare and IT that I found interesting these past few weeks.

All items from Healthcare IT News:

• Standards group offers 10 guidelines to make HIT adoption easier

• Children’s Hospital Boston launches ‘Text 4 Kids’ campaign

• Acute appendicitis – There’s an app for that
  

And 2 conflicting reports:

• White House pushes IT as ‘pillar’ of cost-containing health reform

• Health IT savings estimates are ‘wishful thinking,’ say Harvard researchers

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Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!

In my talks and lectures, I advocate the use of commonly available software in healthcare settings, e.g. word processors in clinics, desktop databases for small hospitals. I see it as the ‘practical application’ of medical informatics concepts. I call that ‘Practical Medical Informatics‘.

The Philippines is a developing country and it lags behind many countries in terms of IT adoption. In healthcare, options for IT applications can be very limited. There may be locally-developed clinic and hospital systems, but widespread adoption is far from ideal and prices can be prohibitive. So we need to be creative when it comes to Healthcare IT solutions.

Many doctors want to be more effective and efficient in their practice management and patient care. They want to document and retrieve clinical data and information, monitor clinic inventory and communicate with their patients—but all within reasonable budget and availability.

If you’re one of them, here’s my advice: Be practical.

Find commonly available commercial software that might address some of your needs. Better yet, look for freeware you can ‘convert’ to clinical applications. Check out software sites for ideas. Try download.com and softpedia.com.

Here are 3 quick tips to jumpstart your version of ‘practical medical informatics’:

1. Word Processors: If you have MS Word or other word processors, create a file for each patient and record visit details in them. Use it like a patient ‘diary’. Use tables and templates to manage data elements that repeat often. Use the patient name as a filename so it would be easy to find.
2. Digital Cameras: Start integrating digital cameras or cellphone cameras into your clinical workflows. In surgery, you can use it to monitor wound-healing. In internal medicine, you can capture rashes and other symptoms. In dermatology, you can get ‘before’ and ‘after’ shots. The possibilities are endless.
3. Photo Management Software: With tools like Picasa, FastStone Image Viewer or IrfanView, it’s easy to manage photos. For better organization, you can use patient names as folders. If you have multiple pictures per visit, you can have subfolders per date. Some of these tools will allow you to add keywords and tags to the pictures making it easy to search, sort and retrieve them.

I’ll elaborate more on these items in subsequent posts. They are just samples of what’s possible. Spreadsheet programs, search engines and, even, email clients carry a lot of potential for more effective and efficient medical information management.

It’s not easy to bridge the digital gap. We need to know what’s available. We need to be more creative. We need to be practical.

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Do you have more suggestions for ‘practical medical informatics’? Do you use ‘non-clinical’ software in your medical practice? I’d like to hear your experiences and ideas.