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4 Reasons Telehealth will Transform Healthcare

There has always been value in being able to reach healthcare consumers remotely, however, the fee-for-service model and health plans have not supported it. Rising expenses, increasing number of Accountable Care Organizations, elevated interest in consumer engagement, focus on population health management and a shortage of healthcare providers are all driving telehealth.4 Reasons Telehealth will Transform Healthcare Andrew Watson, MD predicts that 85% of healthcare delivery will occur in the home in the next five to six years.1 Telehealth provides convenience to an increasingly busy healthcare consumer and expands access to care while reducing costs. Healthcare Providers need to be including telehealth in their plans or they will miss out on a big opportunity to attract and retain healthcare consumers. Here are four reasons telehealth will transform healthcare:

An Increasing Need for On Demand Care - In years past on-demand care meant dropping into a retail or walk-in clinic to get checked out or to get a prescription. Today, on-demand care means online, from the comfort of your home, even in your pajamas if you wish. More and more people are preferring to email their provider questions or video chat rather than stopping into a near by clinic.

Healthcare reform has provided insurance to more than 40,000 individuals who do not have a formal source of care, making them prime candidates to use telehealth. Additionally, there continues to be a growing need for primary care physicians, in fact it is estimated by 2020 there will be a shortage of 20,400 primary care physicians.1 Telehealth provides a great opportunity to expand primary care capacity, tackle the physician shortage and provide convenient and affordable care.

Healthcare Consumers Driving Their Care - Healthcare consumers are becoming more savvy with their healthcare in terms of leveraging their resources and directing their own care based on personal judgement. They are more accountable for their care and taking responsibility for their preventative care plans. Telehealth may just be the solution to meet the needs of the new healthcare consumer who is seeking convenience and ease as they juggle their busy lives.

Regulatory Barriers Being Addressed - The regulatory environment continues to change to help knock down barriers that have stood in the way of telehealth in the past. Reimbursement eligibility for telehealth services is expanding geographically and new laws are ensuring that certain virtual visits are reimbursed the same way in-person visits are. In addition to government mandates, professional groups are focusing on setting guidelines for evidence-based telemedicine and insurers are partnering directly with telehealth vendors to provide virtual care.

An Emphasis on Customer Experience & Continuum of Care - Healthcare consumers are  frustrated with the increased time they spend in the waiting room and the lack of time spent with the healthcare provider.  With an emphasis being placed on customer experience healthcare providers are expanding their hours to accommodate for the demand, however, this is not sustainable. Telehealth also provides a channel for delivering healthcare that can bridge the gap and provide care across the entire continuum leading to better outcomes and an overall improved customer experience.

Telehealth engages healthcare consumers, provides valuable insights for population health management and offers an option that addresses rising healthcare costs and healthcare provider shortages. The time for telehealth is now and providers must leverage it to transform their business models, improve care management and tackle rising healthcare costs.

Look for telehealth to have an enormous impact on healthcare in 2015. Both healthcare providers and health plans need to start embracing telehealth. Check out 10 Trends Impacting Healthcare in 2015

 

Sources:

1 Healthcare IT News
2 U.S. Department of Health and Human Services

 

Telehealth – Impacting Access, Cost and Quality

Where did 2014 go? It flew by…then again after I turned 30, I feel like every year is flying by. As this year Telehealth Impacting Access, Cost and Qualitycomes to a close and planning begins for the upcoming year, like most organizations in the United States, my organization is going through an “open enrollment” period for healthcare benefits, allowing employees to make adjustments to their current healthcare benefits for next year. I rarely change my healthcare benefits. I usually just skim through the HR documents in the slim chance something major changed from the year prior. Ninety-nine percent of the time, nothing changes. However, to my surprise, this year, something maj or, and impressive, did change. For the first time, our healthcare benefits were going to include telemedicine. Amazing!

What is Telemedicine…or is it Telehealth?

Oftentimes we see “telehealth” interchangeably used with “telemedicine,” but there is a slight nuance between the two. According to Dr. Stephen Perkins, Vice president of Medical Affairs UMPC Health Plan, “Telehealth is a general term describing the delivery of health-related services and information by the use of telecommunication technology. It can include phone calls between physicians, videoconferencing or even robotic technology.” Telemedicine has a narrower definition: The specific use of medical information that is exchanged from one site to another via electronic communications for the health and education of a patient or a health care provider for the purpose of improving patient care. It includes consultative, diagnostic and treatment services1.”

The Impact of Telehealth

As the healthcare industry continues to go through major transformation, it is no surprise that healthcare providers are trying to find innovative ways, such as telemedicine, to deliver efficient and effective patient care. Through telehealth, providers can impact access, cost and quality to help achieve this.

  1. Improve AccessibilityTelemedicine allows providers and patients to bridge the distance and time barriers that separate them. Rashid Bashshur does a fantastic job, describing the impact to access of care from both the provider and patient side2:

Providers2: Accessibility for providers in both remote and central sites relates to convenience, opportunity cost, and work load. Providers located in remote and isolated areas and institutions will have ready access to consultants and referral sources. With telemedicine, they may encounter less “red tape” in arranging for both consultations and referrals. Remote providers may be able to alleviate their work load and coverage during off-hours because of their link to medical centers and the use of non-physician providers. Providers located at tertiary care centers will be able to offer their expertise to a much larger and diverse provider and client population compared to those only seen at their medical centers.

Patients2: The target populations and the major beneficiaries of telemedicine are the geographically remote, the institutionally confined, and those otherwise medically underserved, including inner city residents and the elderly. The substitution of telemedicine for person to-person encounters reduces the need for travel and the related opportunity costs and other inconveniences encountered in the process of obtaining care. Instead of having to travel to distant tertiary care centers for specialized, and sometimes even routine, services, residents of rural areas, correctional institutions, and nursing homes could receive an array of services via telemedicine. Only when it is determined appropriate through consultation with specialists would it be necessary for clients to be referred or transferred to be served at the medical centers.

Patients don’t have to live in rural or remote areas to reap the benefits of access to care through telehealth. Access can also be related to sheer convenience. Many of us truly just don’t have time to get to the doctor. Penciling in a lunch-hour visit with our physician can prove challenging, especially when a can’t-miss conference call absorbs the bulk of our afternoon3. According to Jessica Harper, telemedicine eases this problem -through video, Web chat, or phone, workers can follow-up on a prescription or diagnosis with a physician and reduce the time you spend in the waiting room, flipping through yet another mind numbing magazine3.

  1. Influence Costs – Telehealth reduces overall healthcare costs and can potentially generate an increase in revenue.

Contain Cost – The Center for Information Technology Leadership estimates that widespread use of telehealth systems to promote preventive care, early intervention and effective information sharing could save the United States $3.61 billion annually4. Telemedicine reduces travel expenses, especially for those living in rural communities, where they would need to normally travel hours out of their way to access key health services3. In addition, the number of days of work people take for routine visits can add up in lost wages. According to a recent study, with telemedicine, 92% of patients saved $32 in fuel costs; 84% saved $100 in wages; and 74% saved $75-$150 in family expenses5. Even more astonishing, $1.2 billion could be saved by video consultations between doctors and patients in cases where office visits are not practical5. In addition, many providers actual charge less for a telemedicine consultation than they do for a face-to-face visit.

Increase in Revenue- If time and distance barriers to care are removed, use of service is likely to increase, which in turn increases the volume without declining the cost and resulting in an increase in revenue generation2. Improved operations can also prove to be a revenue generator. According to a recent study in Telemedicine and e-Health, hospitals that utilized telemedicine technology and referred patients to other hospital facilities, specifically children’s facilities, saw their revenue significantly increase6. The research looked at 16 hospitals’ billings before and after they implemented telemedicine tools. Before the implementation of telemedicine, the 16 hospitals recorded 143 transfer patients. After deployment the number jumped to 285, resulting in a revenue jump, going from $2.4 million beforehand to $4 million6.

  1. Improve Quality-Enhancing quality of care, through more timely delivery care, care coordination and patient engagement is also an advantage to telemedicine.

Timeliness to Care – The National Healthcare Disparities Report (2009), states that, timely delivery of appropriate care has been shown to improve health care outcomes and delaying health care can lead to a diagnosis at a more advanced disease stage and reduce opportunities for optimal treatment5. The window to receive treatment for many disorders is typically small and early detection and diagnosis can be vital. Ongoing remote monitoring and the ability for patients to check in with providers via telemedicine, before something worse happens, makes a positive difference in patient outcomes and satisfaction7.

Care Coordination – According to Kevin J. Boyle, “Transition care typically includes both patient education and medication management components to help ease the transition from hospital to residential facilities and reduce readmissions. While face-to-face communication is ideal, it is often impractical. Telemedicine provides a quick, convenient and more affordable forum for assessing patient recovery, assisting with medication management and keeping patients on track with discharge instructions. Advanced high-definition video capabilities can also help clinicians’ document key indicators of recovery and conduct demonstrations for self-care or physical therapy techniques8”, especially those with chronic conditions.

Patient Engagement – Providers can involve their patients in their own healthcare, thus improving compliance and, over time, clinical outcomes. Randall S. Moore, MD, MBA, states that, “One of the most interesting and promising outcomes of telehealth programs has been the increase in patient participation and self-care. Because patients have an active role in their care plan and are in more frequent contact with their healthcare provider, they gain a better understanding of their condition and become more compliant in their care.9” Patients want to take a more active role in their healthcare and see technology, such as telehealth, as a mean to helping them achieve this important goal.

Telehealth has continued to grow as a unique way of delivering care to patients, while greatly improving access, reducing cost and positively impacting quality. The number of patients using telehealth services is expected to jump from the 350,000 in 2013 to about seven million by 201810. Despite this staggering increase in users, there are still some barriers preventing its wide-spread use, such as resistance on the part of providers, limited insurance coverage and reimbursement, and privacy and security issues. However, over the past few years these challenges seem to be lessening as the healthcare industry, as a whole, is understanding the benefits of telehealth and from the looks of it, it seems like telehealth is here to stay as a recognized part of healthcare delivery.

What do you think? Do you think telehealth and telemedicine can change the healthcare industry?

Resources for this blog post:

  1. http://www.upmchealthplan.com/pdf/smart_business/February_2014.pdf
  2. http://deepblue.lib.umich.edu/bitstream/handle/2027.42/44995/10916_2005_Article_BF02257059.pdf?sequence=1
  3. http://health.usnews.com/health-news/articles/2012/07/24/pros-and-cons-of-telemedicine-for-todays-workers
  4. http://www.corp.att.com/healthcare/docs/connected_hc.pdf
  5. http://accesstelehealth.org/benefits/lower-cost
  6. http://healthworkscollective.com/waxcom/116071/using-telemedicine-increase-hospital-revenue
  7. http://venturebeat.com/2014/10/20/why-telemedicines-window-is-finally-opening/
  8. http://www.healthmgttech.com/articles/201210/improving-care-coordination.php
  9. http://www.psqh.com/janfeb05/viewpoint.html
  10. http://www.healthitoutcomes.com/doc/barriers-to-telehealth-s-growth-0001

7 Features the Market Wants in Your Patient Portal: Blog Series

In case you missed it, we recently concluded our blog series on What the Market Says You Need in Your Patient Portal. Two of our healthcare experts, Melody Smith Jones, Manager of Connected Health (@melsmithjones) and Nick Lecker, Director of Architecture and Interoperability teamed up to take a deeper look into the 7 features that the market wants in your patient portal:7 Features the Market Wants in Your Patient Portal Blog Series

Healthcare consumers are at the center of the industry’s evolution and patient portals are going to continue to be a vital tool for connecting, engaging and empowering them.

 

Market-Driven Patient Portal: Telehealth Beyond the Virtual Visit

Last month I published a post entitled “What the market says you need in your patient portal” that garnered a lot of interest. In that post I addressed the balancing act that healthcare executives face when market based initiatives are sidelined in order to drive focus to regulatory requirements such as Meaningful Use. Sometimes the market and regulatory requirements are in sync. However, when those regulatory initiatives get delayed things get complicated. My advice is that, beyond Meaningful Use, ultimately the market will determine what true patient engagement means, and I highlighted seven features that a market driven portal should have. I will spend time during this series going into detail on those features. They include:google-smart-contact-lens-glucose-sensor-640x353

  • Telehealth that moves beyond the virtual visit
  • Dynamic scheduling
  • Social collaboration
  • Gamification and serious games
  • Avatars for personalized health coaching
  • Health information exchange across diverse care settings
  • Integration of clinical and financial data

Today we will begin with telehealth. The topic has been in the news quite a bit recently – mostly in terms of telehealth reimbursement. The world of telehealth is not only in a state of transition currently, telehealth is also one of the major net deltas that we will see between healthcare of today and the healthcare of ten years from now. So, what does telehealth look like beyond the virtual visit? We are pushing towards a world where technological innovations will make the brick and mortar less and less relevant even in the world of healthcare. One of the more interesting developments in this area is a push by X Prize, by way of multiple multimillion-dollar prizes, to innovate technologies in such a way to diagnose common medical conditions with no intervention from a health care professional. With this drive in the marketplace in mind, telehealth in a market-driven patient portal you would find:

  • Socially Enabled Patient Portals: In a socially enabled patient portal, physicians and patients can work together toward their combined goals of better health using tactics like dynamic messaging, activity feeds, blogging, and open question forums.  These technologies are particularly effective in rural and low-income areas and are being used to enhance the quality of care for diabetic populations in low-income areas, for example.  These technologies show great promise for providers and health plans interested in managing chronic disease in a cost-effective fashion, especially for the uninsured.
  • Robotics:  Children’s hospitals have been the early adopters of telehealth technologies. Some innovations of interest are in the realm of robotics. Boston Children’s Hospital has an impressive telehealth program with a video-monitoring robot. These 4-foot-6, 17-pound, two wheel robots help with post-operative consultations and care primarily as a means of videoconferencing, giving the families of hospital patients a way to keep in touch with doctors and nurses in between post-surgical appointments. Equipped with cameras, audio gear and a video screen for a “face,” the robots are operated remotely by Children’s Hospital staff. In addition to facilitating communication, they can take video and close-up photos of surgical scars or other key areas of interest to help medical staff monitor recovery.
  • The Smart House: When it comes to uncovering issues early, the tracking of vitals, combined with analytics that readily alert clinicians when those vitals show potential for problem, have been crucial to telehealth outside the virtual visit. We are seeing innovations that embedded fiberoptics into carpeting that can track the activity of patients in and out of their bed while at at home. There is also an innovation called the Health-e-Chair that incorporates a vast array of biosensors to measure vital signs including weight, blood pressure, temperature, ECG, auscultation of heart and lung sounds, blood oxygen saturation, motion analysis and reflex response time. The chair incorporates a communication unit with a remotely controlled camera.
  • Nanosensors: Taking the tracking of remote patient monitoring microscopic is no longer just something we will get to eventually. There are innovations on the market now that can make a big difference in population health. Diabetes is a serious issue in the world of healthcare (understatement of the year award nomination). One of the leading causes of blindness in the world, diabetes patients have a risk of developing retinopathy, which could ultimately lead to blindness. Nanotatoos have already proven out in diagnostic efforts to track blood glucose levels, for example. Google and friends are also innovating around embedded camera functionality into contact lenses to find early signs of diabetic retinopathy.

One in five Medicare patients are readmitted to a hospital within 30 days of discharge, and one in three are readmitted within 90 days. It’s estimated that 75% of all hospital readmissions are preventable. Telehealth provides many benefits as a virtual visit. However, it is taking telehealth beyond the virtual visit that the market will push towards as we work to bring down the cost of care and reduce readmissions. Stay tuned for a future post on how the integration of all of this data takes this effort a giant leap forward.

Anything you think I’m missing? I’d love to hear your thoughts in the comments below.

The “Yellow Brick Road” to Value-Based Care

“The Wizard of Oz” is a wonderful movie, full of metaphors that can be applied to real life. As I look at the current state of Healthcare, I can’t help but wonder if there is a true “yellow brick road” from volume based care to value based care. If there is, which stops will we make along the way and what roadblocks will we face?The “Yellow Brick Road” to Value Based Care

Physician engagement is a crucial component on the road to value-based care. As Michael Porter and Thomas Lee mentioned in their article in the Harvard Business Review, “care fragmentation is reinforced by the fee-for-service model in which each doctor, specialist or otherwise, is paid separately, while the hospital receives its own payment.” They go on to mention that crucial services, like care coordination, are often not reimbursed, thus further fragmenting healthcare.

As our population ages, these crucial components will need to be addressed as practices, hospitals and payers will be flooded with patients needing coordinated services. So how do we engage our physicians in this battle? Like the Scarecrow, listening and learning needs to take place. We can allow clinicians to work to the level of their licenses to unburden the physicians by coordinating patient care and documentation which becomes available for the treating physician.   This will then allow the physician to spend quality time diagnosing and treating the patient, patient and physician satisfaction will rise and overall medical costs will decrease. Payers, Accountable Care organizations (ACO’s), Patient Centered Medical Homes (PCMH) and governmental regulators will see the health care value being generated. With value-based care, these services should be included in reimbursement and quality care should be rewarded. Sounds simple, right?! Read the rest of this post »

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Posted in News

Imagine all the people…without healthcare insurance?

This morning a colleague forwarded a Fast Company article entitled “The Mayo Clinic’s New Doctor is an iPhone.”  The article describes a new Mayo Clinic concierge medicine via mobile device that is subscription based.  For $50 per month (per household) the Mayo Clinic basically offers unlimited access to their nurse’s line powered by iPhone virtual visits.  The service includes:

  • 06FOB-MEDIUM-SPAN-articleLargeReal-time video chats with Mayo Clinic nurses
  • Personally-tailored health information culled from Mayo Clinic databases
  • A “symptom checker” that incorporate’s individual user’s health histories
  • Access to a personal medical concierge who can provide more information or schedule patients’ doctor appointments

Programs like this are becoming increasingly popular.  As I mentioned in the Connected Health trends seriesTime Warner Business Class announced it was venturing into the world of virtual medicine through a partnership with the Cleveland Clinic.  The program is part of Time Warner Cable’s Home Health Monitoring network that was designed to connect healthcare providers to patients in their homes.  It will provide secure, encrypted, two-way video conferencing between patients and Cleveland Clinic providers on a subscription basis. Read the rest of this post »

Trends to Watch in the Healthcare World in 2014

What’s transforming the ways in which healthcare is provided?

  • legislation
  • new competition
  • innovative incentives
  • a call to refocus on priorities
  • a more empowered and digitally engaged consumer, who has more and greater expectations for quality of care and convenience of care.
  • a renewed attention on healthcare by the consumer market thanks to ongoing press about healthcare.gov and the Affordable Care Act
  • new services and business models in healthcare that we’d never seen before recent reform

Susan DeVore, Premier healthcare alliance…and much more.

Susan DeVore, CEO of our partner and client Premier healthcare alliance, wrote a post yesterday fro HealthAffairs.gov titled, “The Changing Health Care World: Trends To Watch In 2014.” In the article, she introduces the new trends she expects to see in healthcare this year. We are also seeing each of these trends impact conversations about investments our clients need to make this year and next year.

I have summarized the trends below.

1. Investments in Chronic Care

  • Chronic conditions increase costs by 3X, so, “The biggest health care consumers are those with multiple chronic conditions.”
  • We should see more investments in Ambulatory ICUs and patient-centered medical homes as providers work to improve their shared savings payments and better manage chronic conditions within primary care facilities.

2. New Job Roles in Healthcare

  • DeVore has seen an increase in the popularity of hiring “health coaches” who are there to listen, inspire and motivate and spend time getting to know the patient’s family and life situation as it affects their ability to both access care and to care for themselves.

3. Home Health Care

  • Back to the days of the house call.
  • “Marketing firm BCC Research predicts that the market for remote monitoring and telemedicine applications will double from $11.6 billion in 2011 to about $27.3 billion in 2016.”
  • Technology is increasing access and convenience of healthcare from outside the traditional care setting, especially for rural, hard-to-access locations.

Read the rest of this post »

Connected Health Trend Countdown: #7 Care Knows No Bounds

Top TenToday’s entry in the 2014 Connected trend Health countdown takes us far away from home:

Trend #7: Care That Knows No Bounds

It wasn’t so long ago when the general consensus amongst healthcare leaders was ripe with uncertainty regarding the returns to be had from telehealth and remote patient monitoring investments.  It’s only a year or so later and these same telehealth programs are now becoming well established at health systems across the country (and around the world).  It seems that the very concerns holding telehealth back in the not so distant past are the same concepts that are driving it forward today.  As mentioned by Gienna Shaw of Fierce Healthcare, telehealth is saving money and extending the mission of better health.

Life Saving Decisions Made from a Distance

Children’s hospitals across the country have been the fastest adopters of mobile health technology.  Children’s of Philadelphia and Boston Children’s Hospital are considered thought leaders in this area.  However, it was a west coast provider that recently got my attention.  In mid-November, I happened upon an article in the Business Journal about how the telemedicine program at Oregon Health & Science University (OHSU) saved a baby’s life.  7 month old MaLea Fox had a very high fever.  Blood work revealed that she had a virus, but after returning home MaLea’s mother was unable to wake her after four hours.  The on duty physician at Columbia Memorial Hospital in Astoria was able to call for a telemedicine consultation with OHSU’s Dr. Jennifer Needle, a pediatric intensivist.  She exambined the child using a two-way communication system with a “robot-like” device.  Dr. Needle was able to see MaLea’s symptoms, which made her look like a burn victim. MaLea was diagnosed with Memingococcemia, which is a life threatening bacterial infection.  Needle advised having a breathing tube inserted before sending her to Portland by helicopter.  Weather made the transport a challenge, which made intubation a lifesaver in this case.  MaLea spent 111 days in Portland and had her leg amputated above the knee.  She is now doing much better and has no memory of the trauma.

Online Medicine Means Big Business

One area of strong growth in telehealth is the area of online medicine, which is more popularly dubbed “virtual visits”.   According to the Pew Internet and American Life Project, 88% of US adults with Internet access research health information online and 60% say the Internet info influenced a decision about how to manage a health condition. Going online is no longer a one-way stream of information from computer to patient.  We are now in the era of web 2.0, which is empowered by social networking. Patients go online to find meaningful engagement with other epatients and, becoming more and more common, with their providers via secured access patient portals.

The results have shown promising enough to elicit private investment.  Time Warner Business Class recently announced it was venturing into the world of virtual medicine through a partnership with the Cleveland Clinic.  The program is part of Time Warner Cable’s Home Health Monitoring network that was designed to connect healthcare providers to patients in their homes.  It will provide  for secure, encrypted, two-way video conferencing between patients and Cleveland Clinic providers.  

We now live in a world where the local hospital is competing with national leaders.  However, the wonder that is social technology has historically favored David over Goliath.  I’m very interested in seeing where this trend leads us throughout the coming year.

 

Making Mobile Medical Apps Just Got Easier

Earlier today, the FDA released its final guidance for developers of mobile medical applications. The FDA is focusing on regulating potentially harmful apps instead of policing applications that pose minimal risk to consumers. These more harmful apps include those which are using mobile technology to make a specific diagnosis and those which medicaltransform mobile devices into a regulated medical device – for example, an app that can turn your phone into a ECG to track heart risks. There are currently thousands of mobile applications currently on the market, with only about 100 that have been approved by the FDA.

With the FDA focusing on mobile applications that work as or with regulated medical devices, telehealth services are likely to be affected. Gaining approval by the FDA will likely be a difficult, stringent process. However, it also will increase the safety and security of telehealth and can lead to better care.

With this relaxed oversight on health apps that are not related to regulated medical devices, do you think we will see an increase in the number of apps available?

Top 5 Technology Trends in Healthcare – August 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

HCBlog Top5 Trends

Personalization of Medicine

Personalized analytics have the power to improve care outcomes for patients by drawing data from a complete view into their care coordination. Healthcare analytics and big data hold the key to being able to provide personalized care and prevention. By integrating personal health records with EMR data, providers have a 360 view into the history of the patient and the care they require.

Interoperability

Interoperability plays a key role in ensuring systems can communicate with each other to share information. It helps to reduce redundant data entry, speed access to information and create a real-time flow of information through an enterprise IT system. The key benefit of creating interoperability is to improve the visibility, sharing and re-use of data collection between disparate healthcare applications and devices.

Read the rest of this post »

Innovative Medical Education…Can it Save Healthcare?

Is there such a thing as “disruptive medical education”?  Can traditional medical education be infused with technology, techniques and individualized learning such that it creates the next generation of enlightened and empowered physicians?  I think so.  Years ago, when I was enrolling in medical school at Case Western Reserve University, I felt like I was a part of just that…exciting, cutting edge education which was “disrupting” the traditional training by allowing students to start interacting with patients immediately.  So I was intrigued when I read about a new program starting at Brown University’s Alpert Medical School in 2015. This program focuses on combining Ausmedschoolpopulation health management and primary care to create physicians who are focused on the principles of the Triple Aim: improved outcomes, better quality healthcare delivery, and decreased cost of care.  But will it work?

As everyone knows, the cost of healthcare is astronomical.  Federal mandates and regulations abound.  To survive in this landscape, physicians need to understand these increasing pressures and begin to embrace the tools which will allow them to provide improved outcomes, better quality of care and do it with less cost.  It seems to me that educating our next generation physicians and arming them with these tools to succeed only makes sense.  Social media, mobile health, telehealth, population wellness, and more are all here to stay.  Patient engagement in healthcare is rapidly evolving and will be an integral part of any health system of the future.  Medical education needs to change and not stagnate.

So my answer is this:  I am hopeful that we choose the right path and decide to disrupt medical education.  I encourage all of the cutting edge, forward thinking, connected educators to lead the charge, just like those at Brown are currently doing.  Just like Case Western Reserve University’s Medical School did several decades ago.  Do you think it will happen?

Hang on; I’m getting a notification from my body on my phone

Today I heard an airplane defined as a number of parts flying in formation.  That is an accurate description of an airplane if your work is to maintain or repair airplanes.  But that definition isn’t right for marketing air travel to people who fly as often as I do.  I would prefer to know that the whole airplane, including the human crew, is going to get me to my destination safely and on time.  The idea that wireless sensors implanted in your body that feed information to a smart phone can help maintain your body like a number of parts, walking, running, driving or flying in formation is very exciting.  It is sensational to think that we could collect minute by minute information to manage our body and take actions to prevent or control chronic illness. The idea that a diabetic could wear or have an implanted device to monitor blood glucose levels and then have that device wireless talk to an insulin pump could be a real game changing event for all types of diabetics.  Close control of blood glucose levels really helps prevent implantdevicedamage, sometimes irreversible damage to the body, for example.  How about a real time wireless notification when blood sugar levels are too low, like when you are sleeping, for example?  Better yet, an alarm that notifies you and someone else to check on you.

There is an excellent article about the research on wireless sensors implanted in the body to provide medical information at “The internet of you: How wireless medical implants will change medicine”.  The article captures the challenges faced by implanting silicon based chips and how quickly the body will attack and try to repel them out of the body. However, having personally seen the success of implanted devices to monitor and manage epilepsy in children, this type of research deserves more attention and funding to make breakthroughs.  Instead of a large belt-worn device wired with electrodes into the brain, how about miniaturization into a small waterproof hearing aid sized device?  The potential is definitely there for real breakthroughs.  A great example is using tiny nerve signals to control prosthetic devices to allow more sophisticated fine motor skills.  The ability to tap into the auditory nerve to address hearing loss is another example where the device may one day be implanted and then wireless stream signals to an external device. Read the rest of this post »