Build health literacy one educated patient at a time
Did you know health illiteracy kills?
Md2p.Net
Is illiteracy a result of poor design. Do we make it readable? Do we make it understandable?
Is 5th grade literature effective?
Thursday, November 18, 2010
#health2stat dammit Jim I'm a doctor not a bricklayer! Md2p.net
Build health literacy one educated patient at a time
#health2stat patient to patient
10k patients per year with rate diseases
Patient portal to provide info on patient conditions
Available at the bedside. Launched in 2006
Links to practical info but no patient interaction but no peer to peer info.
CarePages is an interactive community on portal. Most used pages on the portal.
Funding has disappeared.
Thanks @ginnyhill
#health2stat IPM collaboration
Delivering microbicide solutions to combat HIV
Quick wins to create a snowball effect
Iteratjve
Apply three C's
Communication - over communicate
Don't under estimate users lack of skills
Used centered design = common sense
#health2stat how to use social media
Welcome but don't immerse
Inform
Entertain
Inform
Entertain
Provide diversions
Virtual. Gifts are the though that count
Contests with desirable prizes. Get the community to vote
Build community with live events
Upload the photos and get people to tag and vote
Short- I said really short videos
Improve recruiting because you have good social media skills
Thanks jacquelyn kittredge
#Health2stat some great presentations in store
Hot dogs flip flops and shorts
Social media is a cocktail party. Facebook is a backyard BBQ
Don't bring your mission statement to you Facebook page. Instead live it!
Sunday, November 14, 2010
#hcdc10 After HealthCampDC @carefirst - HealthCamp: the next steps
It is Sunday Morning and an opportunity to sit and reflect on another vibrant HealthCamp.
Friday November 12th saw HealthCampDC take place at CareFirst's DC Headquarters. CareFirst was the headline sponsor, providing the facilities, the food and the network access to the world (or at least a large part of the Internet). We were also lucky to have the generous sponsorship of Cybercise, HealthCentral and YourNurseIsOn.
HealthCampDC had a great mix of experienced HealthCampers and people completely new to HealthCamp. I know that the event had a lasting impact on those first timers. You just had to look at their bulging eyeballs where braincells had been gently, but irreversibly, re-arranged as a result of the vibrant discussions and exposure to new, but practical ideas.
Listening to the wrap up session was inspiring. One innovator asked if anyone knew of any clinics where they could test SMS messaging for improved adherence and an immediate volunteer stepped forward with access to over 100 clinics. When connections like that take place it convinces me of the importance of HealthCamp in promoting the discussions around participatory healthcare.
People often ask - "Where does the money go"
At HealthCamp we strive to keep participant ticket costs down. But yes, we do charge. Why you may ask?
We have found that charging a nominal fee simplifies the planning of the event for the volunteer organizers. That nominal fee dramatically cuts the "no show" attrition rate. When people have paid they tend to turn up. When the event is free people figure there is no loss when they don't show. The nominal fee helps cover one of the important elements of HealthCamp - The food! and makes planning and waste less of a problem.
For each event the fees and sponsorship cover:
- Food
- Location (some events have to pay for facilities and support, often including Internet access, for example when using a university campus)
- Supplies to support the event (name tags, flip charts, marketing materials, the materials to construct the agenda wall)
- Shwag and prizes. (We keep these to a minimum since every dollar spent here is a dollar that has to be raised. Yes T-shirts are expensive!)
- Marketing, PR and other services (the professional videos produced after some events don't come for free )
HealthCamp has been entirely self funded thanks to the contributions from participants, friends of HealthCamp and event sponsors. At many events we manage to break even. At some events we are lucky enough to have a small surplus. The surplus from those events goes towards:
- Planning future events
- Purchasing Internet services (Video sharing and Web sites, Domain names etc.)
- Software and equipment that supports events
- HealthCamp's next step
Yes, HealthCamp is ready to take the next step.
It has long been our objective to establish the HealthCa.mp Foundation. The purpose of the Foundation being to act as a catalyst for HealthCamps around the world. As a central, non-profit foundation it will provide promotional materials, the digital footprint and logistical support to make it easier for local HealthCamp organizers to put on an event.
HealthCamp is fortunate to be able to point to a growing list of prestigious and forward thinking sponsors such as Kaiser Permanente, Microsoft, IBM, CareFirst BlueCross BlueShield, BlueCross BlueShield of North Carolina, YourNurseIsOn and Kony Solutions who have hosted an event or supported multiple events. This list is an asset to local volunteer teams and can help break the catch-22 when seeking a location and sponsors.
HealthCamp also counts itself fortunate to have a growing band of advocates such as Maumi Cannell Chatterton (@mjchatter), Gregg Masters (@2HealthGuru) in San Diego (who is behind HealthCampTV and our BlogTalkRadio presence), Mike Kirkwood (@mikekirkwood), and Maren Connary (@marenconnary) who have worked tirelessly behind the scenes to promote HealthCamp.
HealthCampDC, which took place on November 12th, was fortunate to have CareFirst as a facilities sponsor. Their generous sponsorship, when coupled with the sponsorship contributions from Cybercise, HealthCentral and YourNurseIsOn and the Friends of HealthCamp donations from @MeredithGould and Bob Blonchek's @RazCode, plus the participation of everyone else that purchased tickets has finally put us in the position where we can take the next step.
So, over the winter we will be establishing the HealthCa.mp Foundation as a non-profit organization and will be seeking board members and advisory board members who reflect the different regions in which HealthCamps take place and the different skills we need to create an active board. This will provide the platform for HealthCamp to have an even greater impact in the years ahead.
Wish us luck as we take this next step. We really appreciate your help and support.
Friday, November 12, 2010
#hcdc10 @cybercise and the crew at healthcamp redesigned a healthy food label
Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone
#hcdc10 a word cloud as the group talks about data visualization
Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone
#hcdc10 @dcpatient massive missed education opportunity in hospital to teach about meds before discharge
Best quote from healthcampdc "this is super secret" - HealthCentral
#hcdc10 700 steps in hospital between doctor RX and patient taking pill
alex fair of faircaremd asked what can each of us do to improve and reduce the 700 steps
AdhereRx is doing something interesting around remote adherence solutions.
We need to remember the trust circle in the caregiving delivery. Enable the patient support team.
If airline industry was like medical we would have a plane crash every day.
Airline industry has 2 good things: checklists and no blame approach.
Alex fair - what can we DO
@Reginaholliday - what if we added a text short code to the ask the pharmacist sign at the pharmacy. Allow a private conversation with the pharmacist.
Use hospitalization as an education experience opportunity.
We need continuing conversation to reinforce information exchange and patient understanding.
#hcdc10 lots of interest in common issues at @carefirst healthcampdc
Lots of thoughtful people collaborating
How to improve medication adherence at #hcdc10
Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone
Hcdc10 discussing practical solutions for better health
Great discussions - @aviars "gluttony is the only acceptable deadly sin"
#hcdc10 fascinating discussions
DC seen as thinnest "state" but actually greatest extremes. Some areas anorexic southeast district is fatter than states like Mississippi
#hcdc10 Patient centered or primary care medical home
The PCP is the quarterback. PCMH rewards OCP to focus on critical and High risk members. Looking at unified communications and nursing coordinators to help support pcp's. Launches in January 2011.
Docs Want information. But also want patients engaged. Patients need incentives. HealthyBlue is this program.
#hcdc10 Kevin O'Neill of @carefirst addressing the camp
The #hcdc10 HealthCampDC wall is up
We will post the session titles to the wall at http://bit.ly/hcdc10wall
Wednesday, November 10, 2010
#WHIT Panel session on intersection of Meaningful Use, Quality, IT and timelines.
WHIT - the last gasp....
| 12:00 pm - 1:00 pm |
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Dr. Thomas Tsang, Medical Director, Office of the National Coordinator
Dr Greg Pawlson - NCQA
Moderator of the discussion: Tina Olson Grande - Policy HealthCare Leadership Council
Dr T Tsang: 1st Macro challenge is the more integrated system. Current system is fractured and siloed.
2nd Macro challenge HIT and PHR is shifting the paradigm to Consumer centric
The real potential is being able to measure effectiveness. embed knowledge and evidence-based practices in to daily workflow.
Population data has a big future in quality measures. We will move from static measures to measuring change.
Peter Basch: We don't know what the ceiling on excellence is. We are now starting to look at the Patient and Doctor stellar performers and work out how to spread the word and practice on that.
Thomas T: Great opportunity to incorporate measures that matter to the patient.
Greg Pawlson: Medical Home - There are plenty of people that can manage the care of a patient. Doesn't have to be just Physician centered.
Thomas T: Federal realization that we need more longitudinal measures. Move away from the checklist method of quality. Use measure that really measure the outcome for a patient.
My Note: A couple of years ago someone at a Web 2.0 Expo said "Quality of Life" will become a real measure across many industries. That is so true. How come the one industry that has quality of life at it's core doesn't have a quality of life measure.
Thomas T: Indiana has 5 exchanges for providers to choose from. Good for competition and choice.
My Note: Does that cause fragmentation? Can a provider still get to everyone or only to those in the same exchange?
Paraphrase Peter B: when you make it easy to do - people do it. Doctors or Patients. Make it easy for Doctors to compare their performance and their competitive instinct pushes them to see how they compare. Next comes the question - how can i do better.
#WHIT Healthcare innovation - real world lessons from Early EMR and HIE adopters
Getting closer to the finishing line at WHIT:
| 11:00 am - 12:00 pm |
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Peter Basch: Been using EMR since Mid 1990's.
Pamela A: The organization believes in Technology. So there was leadership support.
Look at how you translate data to information to get value from the system.
Focus on System Ambassadors from amongst the early adopters.
Look at usability. don't make it "too many clicks"
Email in the patient Portal is not email. It is a workflow. You typically want to route email so it is screened before it gets to the doctor. The doctor is usually busy with patients so you want to be able to have the team or front office staff review and triage first.
Don't over design security. If not careful you end up defining roles that prevent users from getting to information for patient care that they need to see. Move to a trust but verify model?
Does the system have one page that "summarizes the patient story"
Peter B: Triangulate the doctor patient and screen. "Let's verify together"
The value of the EMR is when information is used to deliver better patient care.
"Process enable by Technology"
Pamela A: Think about how work shifts and move staff to handle the load. Work load will change over time. You need to plan for the transitions.
Jennifer C: What do you wish you had known before you started?
Peter B: It's going to be hard work. Be prepared for backlash - Remember you are working with a highly skilled workforce running a complex process that on the whole works. Dark days pass.
Sue Schade: Think about whether a best of breed strategy is necessary. Systems are improving so an enterprise solution may be more effective.
Mike Sauk: Deploy on a clinic/specialty basis so teams end up asking why they can't have what the other teams have. Budget for surgery furniture redesign. You don't want the doctor with their back to the patient in order to use equipment.
IT or Business Led project - Sue S - It 's a partnership.
IT has expertise but the Docs and Clinicians have to live with the product.
IT provides the information to enable an informed decision but the business leaders make the call.
#WHIT @lygeia Riccardi moderating a panel - the Next gen of connected Health PHRs v EHRs
More from WHIT:
| 9:45 am - 10:30 am |
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Also on the panel: Donna Cryer @dcpatient
Wow - a Patient on the stage at WHIT!
Changing Demographics will drive adoption of electronic solutions. Changing Expectations will drive the change.
Bill C: when systems become transactional and data is provided FOR me then usage of PHR's / EHRs will take off.
Linda F: VA asks their Vets want functionality they want using online survey tools.
Donna C: Patients are very practical - is it a good use of my time. What about Patient Efficiency!
Bill C: Payers are starting to "get it" change the payment system to change behavior
Bill C: The value doesn't come from EMR - it is what you do next that counts.
Linda F: some "deviant" communities that have adopted EHRs at 2-3 times the national average. Rural areas often have their act together. Using technology to break down barriers of time, distance and geography.
Donna C: "when you give the same information to the same healthcare organization multiple time I am thinking - You could kill me"
Ed G: The industry has no incentive to share. It is up to the Consumer.
Ed G: We need to change business models
Bill C/Linda F: It is not PHR v EHR it is PHR + EHR
#whit Bill Crounse (@MicrosoftMD) talking about commodity IT in health
More from WHIT:
| 9:15 am - 9:45 am |
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America is so far behind on Electronic Health Records....
Real time web - only 1.6B have adequate coverage.
Trends in e-Healthcare:
- online appointments scheduling
- web messaging with physician and support staff
- Access to lab and radiology
- Rx Refills
- Reminders and information therapy
ghc.org - MyGroupealth shown as an example of the future.
80% of patients online
30% of activity is now performed online rather than at doctors office.
Healthcare.gov- The government is stepping up.
Todd Park, CTO of HHS was included in a video interview.
President Obama, as his own suggestion, recorded a demo of using Healthcare.gov.
Reference also made to BlueButton initiative and how that data can be extracted and imported to PHRs like HealthVault.
HealthCare is going consumer-centric.
All the data for all of your life in one place.
MayoClinic HealthManager was shown (powered by HealthVault)
Showed an example of how health information and exercise can be recorded in custom trackers which users can use to correlate issues like Migraine with activity, diet, sleep and exercise.
HMSA in Hawaii recognized as using HealthVault powered by American Well for online care.
"The Power of Commodity"
- Unified Communications
EMR needs to be like Cable TV. Plug it in, pay subscription, use it.
Another example: Wound Management with satellite communications and community nurses. Saving hospitalization at rate of $72k per patient.
"To the Cloud"
Public or Private doesn't matter.
Put the patient at the center. Give them the PHR - Don't we eliminate the need for NHIN/HIE/RHIO?
As the patient moves through the system their data moves with them.... so much simpler.
We are moving to new user interfaces with anticipatory features.
Surface now evolving to No touch and 3D
now we have XBox Kinect. It sits in your living room and follows your movements and knows who you are. Can provide video conferencing in the living room.
check out Bills. Healthblog http://blogs.msdn.com/healthblog
Medical Tourism is very real. My thought is that American Well's online care technology is providing amazing potential for virtual medical tourism.
Health Insurance is a misnomer. You will always need to use the services covered by Health Insurance.
#WHIT Moving to meaningful use with MedPlus (Quest) Care360.
More from WHIT
| 8:20 am - 9:15 am |
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Greg LeGrow talking about Care360 EHR pilot at BCBSMA
Only 32% of small physicians have an EHR solution.
Lessons learned:
- Active Physician Champions are vital
- Sponsorship and Financial Subsidies
- Choice of Lab and Radiology to address lock in fears
- Provider Advisory Group online community to increase level of engagement and peer support
Dr Paulo Andre:
EHR features required:
- Web Based
- Share data across the network not just in a practice
- Clinical notes
- Clinical messages
- Tests: Lab results, images etc.
Most EHRS made it difficult to share online, had a big learning curve, disrupted workflow and productivity, were complex and expensive ($500/month and $40k/Doctor)
They wanted something as simple and flexible as gmail.
MedPlus Care360 provides:
- web-based
- Easy sharing
- Disease Registry and able to send HEDIS quality feedback via EHR Message system
- Flexible data input: type, Speech recognition or upload transcriptions
- No impact to patient throughput - workflow doesn't impede workload
- Online upgrades make it easy to maintain
- Intuite and minimal training needed.
Phase 1: e-perscribe, Messaging
Phase 2: EHR with notes.
- Accessible from iPhone and iPad.
MetroWest experience:
100 Physicians in 40 Facilities selected Care360
74 from 30 facilities have activated Care360.
59 Physicians at 27 facilities are using Care360 daily.
Paper to Electronic transition in 4 weeks.
Meera Kanhouwa, MedPlus:
MedPlus: >160k physicians and >70,000 Practices
>120 EMRs
MedPlus is an IT subsidiary of Quest Diagnostics.
Average time to deploy is 16 business days.
94% of all US Practices are 5 physicians or less.
4,500 physicians in Maryland are connected.
- 40B Lab Results for 120M patients.
- Medication History, inc. Vaccines and allergies.
Quest connects to Google Health, KEAS and Microsoft HealthVault.
Care360 Mobile on iPhone/iPad.
Partnership with HP to deploy equipment and connectivity.
Actively involved with RECs.
Subscription based system. Data is not held hostage.
Care360 is a hosted single instance system. Every physician (172,000+) on Care360 is in the network.
Interesting note:
10 Physician referrals increase a hospital bottom line by $1 M to $1.5M.
#WHIT bright and early session on Accountability through Analytics
More from the last day of #WHIT...
A presentation by MDI and Analytics Partners on Accountability through Analytics
Lisa Davis, CEO of Analytics Partners and Cary Smith, VP of Business Architecture at MDI.
| 7:15 am - 8:10 am |
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Both companies are based in Jacksonville, FL.
MDI started developing networks and analytics for prisons. MDI offers a Software as a Service Analytics solution. They have an interesting claims analysis drill down based around a body map.
Cary Smith:
Incentives emerging for Value-based decisions. Evidence-based medicine. NCQA put out draft standards that may influence ACO management.
Accountable Care Organizations will be judged based on their performance.
A fascinating discussion ensued with the audience. A quick summary.... When patients have developed a condition measurements around the condition don't necessarily improve the outcome. The best option is to identify the condition and work out how to measure the pre-cursors to the condition and watch for it in order to take corrective action early. However, up to now the spending on lifestyle coaching has not paid off. I believe that the reason it has not paid off is that we have not worked out how to integrate the coaching in to the "Rhythm of life" of those individuals.
Is Medical Home a competitor to ACOs?
Companies appear to be ready to move forward with ACOs regardless of the outcome of the recent elections.
#WHIT The final day of the conference and I am the only person here with an iPhone App that connects to my PHR
More from #WHIT....
| 8:10 am - 8:20 am |
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I appear to be the only person in the audience with an iPhone App that has a link to my health record....
Tuesday, November 09, 2010
#WHIT closing session from Day 2
More from WHIT:
Availity (who recently purchased RealMed) talking about connectivity between HealthPlan, Provider and Patient.
| 4:45 pm - 5:30 pm |
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Catherine Peper taling about next generation of HIT systems
- Industry Standards codes and formats
- PCMH and other emerging models
Competitors have to cooperate
Multi-Payer solutions are essential.
"Payers spend a lot to look different. Providers and integrators spend a lot to make payers look the same."
Availity & Humana drive market leading adoption:
Electronic Transactions:
97% E&B
90% Claims Submissions
72% claims status
70% E remittance Advice (big focus area)
36% EFT
25% Auth/Certs
26% e-RX
10% CareCalc
<1% ACP
Driving to 95% of all transactions being Electronic.
New in 2011:
- Enhanced Clinical Reviews
- Coordination of Benefits (e-COB)
- Care Opportunities / gaps in real time
- e-Campaign/contact management
- e-Appeals
Challenges:
ANSI 5010 - 1/1/2012
ICD-10 - 10/1/2013
Extreme Standardization coming immediately afterwards.
AHIP: ICD-10 will cost average Health Plan $12/Member
Alternative Care Delivery, Financing and Funding:
- Patient centered Medical Home
- e-visits / online care / telemedicine
- Accountable Care Organizations
- Gain Sharing
- Bundled Payments
- Collaborative Care
We need to address standardization of clinical quality measures otherwise we will drown clinicians.
Joe Taylor: VP and Enterprise Process Leader - CEBS
In clinical - If you build it they don't come. You have to integrate and meet the clinician where they want to be.
We need a coordinated Partnership, Technology and Reimbursement Strategy
Practice Criteria and capabilities:
How ready is the practice? Access, EMR, NCQA criteria etc.
Shared Data on Gaps in Care via Clinical Connectivity - can you leverage MedDecision, Availity etc.
Use of High Value Efficient services - Specialist, Hospitalists, Ancillaries
Joe Taylor: Not sure how HIEs will work in practice.
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