Connected Health Symposium 2009 Wrap-up

Connected Health Symposium 2009 Wrap-up

I attended the Connected Health Symposium last week in Boston and got a healthy dose of the past, present and future in health care connectivity, connectedness and connections.  As always, I enjoyed connecting in person with a whole host of folks I know online — including those who know my twitter handle, @healthblawg, better than my name.

The conference was kicked off by Stuart Altman, who regaled us with tales of his days with the Nixon Administration, and made a couple of key points:

  • The health care spending crisis is cased by rising prices, not rising utilization
  • Any federal health insurance reform will cause cost-shifting to the privately insured, the states, the young
  • Therefore the key to successful reform lies in reforming the payment system as well as the delivery system; otherwise we’re “trying to grow flowers in a toxic environment.”
  • Value-based purchasing (P4P), gainsharing, global payments are reasonable options for payment reform
  • Incentives for providers to use home-based systems will help heal the system at large, and promote connected health, which in turn promotes quality and efficiency

(But n.b.: while remote monitoring and home care will improve quality and reduce cost overall, it is not necessarily cost-effective for every patient.)

To read the rest of Connected Health Symposium 2009 Wrap-up

Dedicated stroke unit to be built at Perth Royal Infirmary

move will ensure ‘best standard of care’ for patients

By Leanna MacLarty

Published: 28/10/2009

A DEDICATED stroke unit is to be built at Perth Royal Infirmary.

Acute stroke victims who are usually sent to the hospital’s general medical ward will soon get treatment in a specialised ward.

Perth and Kinross Community Health Partnership said the move followed a review of treatment for stroke patients.

The Perth hospital already has an eight-bed rehabilitation unit for stroke patients but it does not cover the most serious cases.

The new unit will be an expansion of the existing rehabilitation unit, bringing the number of beds up to between 20-22.

It will also include a specialised six-bed section for acute patients.

The new unit is expected to be up and running by December and will allow acute patients to be treated in the same place by specialist staff.

Service designed from the patient's point of view.

Submitted by John Farrell on Mon, 10/26/2009 – 3:46pm
in Data management, Healthcare IT, Mobile Point of Care (MPoC), health IT, mobile point of care, mpoc
John Farrell's picture

As a general rule, I limit my focus on mobile point of care technologies to organizations that are actively positioning themselves within traditional healthcare settings. But with increasing emphasis being placed on heading off hospitalizations and physician visits by targeting the needs of patients in the home–and since HealthcareGoesMobile.com is all about building community within the healthcare space–it seems reasonable to mention a new start-up that’s currently beta testing an online personal health care management service designed from the patient’s point of view.

Although the service isn’t expected to go live until January, RememberItNow! founder and CEO Pamela Swingley tells me her company’s offering–which bundles SMS medication reminders, event reminders, two-way communication and the ability to create an interactive private care community–will provide patients, their family members and their caregivers with an extremely easy to use health care management tool.

To read more about patients point of view

Mobile and Fixed Computer Use by Doctors and Nurses on Hospital Wards

Mobile and Fixed Computer Use by Doctors and Nurses on Hospital Wards: Multi-method Study on the Relationships Between Clinician Role, Clinical Task, and Device Choice

Pia Andersen1, BSc; Anne-Mette Lindgaard1, BSc; Mirela Prgomet2, BAppSc(HIM); Nerida Creswick2, PhD; Johanna I Westbrook2, PhD

1Medical Informatics Group, Department of Health Science and Technology, Aalborg University, Denmark
2Health Informatics Research and Evaluation Unit, University of Sydney, Australia

Corresponding Author:

Johanna I Westbrook, PhD

University of Sydney
Director, Health Informatics Research & Evaluation Unit
Faculty of Health Sciences
PO Box 170
Lidcombe 1825
Australia
Phone: +61 2 9351 9677
Fax: +61 2 9351 9676
Email: J.Westbrook [at] usyd.edu.au


ABSTRACT

Background: Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions.
Objective: We aimed to investigate the relationships between clinician role, clinical task, and selection of a computer hardware device in hospital wards.
Methods: Twenty-seven nurses and eight doctors were observed for a total of 80 hours as they used a range of computing devices to access a computerized provider order entry system on two wards at a major Sydney teaching hospital. Observers used a checklist to record the clinical tasks completed, devices used, and location of the activities. Field notes were also documented during observations. Semi-structured interviews were conducted after observation sessions. Assessment of the physical attributes of three devices—stationary PCs, computers on wheels (COWs) and tablet PCs—was made. Two types of COWs were available on the wards: generic COWs (laptops mounted on trolleys) and ergonomic COWs (an integrated computer and cart device). Heuristic evaluation of the user interfaces was also carried out.
Results: The majority (93.1%) of observed nursing tasks were conducted using generic COWs. Most nursing tasks were performed in patients’ rooms (57%) or in the corridors (36%), with a small percentage at a patient’s bedside (5%). Most nursing tasks related to the preparation and administration of drugs. Doctors on ward rounds conducted 57.3% of observed clinical tasks on generic COWs and 35.9% on tablet PCs. On rounds, 56% of doctors’ tasks were performed in the corridors, 29% in patients’ rooms, and 3% at the bedside. Doctors not on a ward round conducted 93.6% of tasks using stationary PCs, most often within the doctors’ office. Nurses and doctors were observed performing workarounds, such as transcribing medication orders from the computer to paper.
Conclusions: The choice of device was related to clinical role, nature of the clinical task, degree of mobility required, including where task completion occurs, and device design. Nurses’ work, and clinical tasks performed by doctors during ward rounds, require highly mobile computer devices. Nurses and doctors on ward rounds showed a strong preference for generic COWs over all other devices. Tablet PCs were selected by doctors for only a small proportion of clinical tasks. Even when using mobile devices clinicians completed a very low proportion of observed tasks at the bedside. The design of the devices and ward space configurations place limitations on how and where devices are used and on the mobility of clinical work. In such circumstances, clinicians will initiate workarounds to compensate. In selecting hardware devices, consideration should be given to who will be using the devices, the nature of their work, and the physical layout of the ward.

(J Med Internet Res 2009;11(3):e32)
doi:10.2196/jmir.1221

KEYWORDS

Study; multi-method study; observational study; mobility; mobile computers; computers; computer hardware; medical order entry systems; computerized physician order entry system; computerized provider order entry (CPOE)

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NHS told to improve oxygen care

By Nick Triggle
Health reporter, BBC News

Oxygen therapy patient

The NPSA is concerned about standards in hospitals

Concerns are being raised that patients receiving oxygen treatment are being put at unnecessary risk because of poor monitoring and faulty equipment.

The National Patient Safety Agency has given hospitals in England and Wales until the end of March to improve.

The watchdog said it was acting after receiving reports of people dying and being seriously harmed due to problems.

Experts said despite over 2m people getting oxygen treatment each year, it was still not being prioritised enough.

The therapy is given to a range of patients, including people with lung problems, trauma patients and those struggling with serious infections.

For more on oxygen care

Migraine Monitor site wins award

[Posted: Mon 19/10/2009]

Migrainemonitor.ie, the innovative website developed by Irishhealth.com has won the ‘Best Use of Information Technology’ in the The 2009 Irish Healthcare Awards. The initiative aims to support and help minimise the impact of migraine on sufferers, family, work and social life. It was developed with the support from the Migraine Association of Ireland (MAI). 

The system uses technology to allow patients better manage their migraines, by quickly and easily updating their personal online Migraine Monitor Diary direct from their mobile phone via SMS. This diary then assists them, and their healthcare professional, to identify trigger factors for their attacks and frequency, which helps to improve the management of migraines. Traditional methods of documenting attacks involve patients recording details in a paper diary before visiting their healthcare professional, which led to patients forgetting or misplacing their diaries, as well as issues around legibility and difficulties in analysing manually entered data. 

To use the service, people first log on for free registration with Migrainemonitor.ie and from that point whenever they experience a migraine attack they can directly update their records by texting the word ‘PAIN’ and the level of pain intensity (scale of 1-10) being experienced to the number 57500. A comment can also be added to this text message, such as timing of attack, related trigger etc (e.g. PAIN 5 – felt ill last night). Users can also log on to the website and add further information about that particular attack to assist in identifying any common patterns or causative triggers. The service also allows them to print off their personal record and bring it to their next healthcare professional visit. 

Several hundred people have already registered and regularly use the website, launched in March of this year, with around 5,200 ‘unique visitors’ having logged on, viewing in total over 16,500 pages. In addition to this existing patient service, there are plans to develop the service further to allow healthcare professionals log in and remotely review their patients’ records – representing a real step towards the gold standard of telemedicine. 

According to the MAI, around half a million people in Ireland live with migraine. The condition is estimated to cost Irish businesses €250 million every year as a result of loss in productivity, with the average sufferer being absent from work between 1.5 and 4.5 days annually.  

Find out more about migrane monitor here

Industry leaders debate mobile health at TechnologyWorld09

Cambridge Wireless Healthcare Special Interest Group will tackle some hard questions facing healthcare systems around the world during its ‘Mobile Health’ seminars at TechnologyWorld09 (23 to 24 November).

The UK is at the forefront of the health technology sector, developing solutions to address issues facing ageing developed economies, growly sophisticated developing economies and public expenditure constraints

With NHS’s high level of IT investment 98% of British GPs use IT systems for electronic medical records. According to NHS Connecting for Health technology, has saved the NHS at least £208 million.

During UK Trade & Investment’s (UKTI) TechnologyWorld09 speakers from Hidalgo, Orange, University of Birmingham, MiLife and iPLATO Healthcare will debate how the UK’s wireless technology sector will help primary care, hospital, social care and consumer products.

Themes explored includes wireless in health monitoring in tough environments, e-health, body area networks, a revolution in personalised preventative health systems and linking GPs and their patients for efficiency and health promotion.

Cambridge Wireless CEO Soraya Jones said:

”Cambridge Wireless is delighted to work with UKTI to deliver a world class series of seminars on mobile health. These seminars will address and tackle the issues on the use of technology to help the increasing ageing society of our future.”

The Cambridge Wireless Healthcare Special Interest Group seminars are championed by Networks for Independent Living’s David Cudby, TTP Group’s Michael Lukin, Cambridge Consultants’ Paul Williamson, CSR’s Arif Rahman and Airwave Solutions’ Justin Paul.

Delegates attending TechnologyWorld09 can register to attend the seminars as part of the meeting booking system.

TechnologyWorld09 is one of the UK’s largest technology meet-the-buyer events. The two-day event at the Ricoh Arena, Coventry gives British firms a platform to build international business. Over 200 delegates have already signed up. Last year TechnologyWorld09 generated an estimated £30 million in business deals for attending companies.

For more information on the Cambridge Wireless Healthcare Special Interest Group seminars visit http://scottishhealthcare.co.uk/tw09

Leeds University research into longer lasting body replacement parts

Science to ‘stop age clock at 50’

By Michelle Roberts
Health reporter, BBC News

Elderly lady

Replacement body parts could last much longer in the future

Centenarians with the bodies of 50-year-olds will one day be a realistic possibility, say scientists.

Half of babies now born in the UK will reach 100, thanks to higher living standards, but our bodies are wearing out at the same rate.

To achieve “50 active years after 50”, experts at Leeds University are spending £50m over five years looking at innovative solutions.

They plan to provide pensioners with own-grown tissues and durable implants.

New hips, knees and heart valves are the starting points, but eventually they envisage most of the body parts that flounder with age could be upgraded.

Read more about this research

Joseph Rowntree Foundation study emerging technologies to provide elderly at-home care.

The future’s bright, the future’s talking Zimmers and robo-pets

The technology used in robots such as Asimo may be used to help elderly people stay independent
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Published Date: 20 October 2009
By Craig Brown

WALKING frames that remind their users where they are going and coffee tables that act as home medicine dispensaries are just some of the technologies that could help cut down on care home bills and help older people live at home for longer, new research has suggested.

In the next 15 years, the number of over-65s in the UK is expected to increase by more than three million, and the number of dementia suffers is also predicted to rise.

A study by the Joseph Rowntree Foundation Centre for Usable Home Technology at the University of York has recommended that to manage the pressure on services this rise will bring, councils could use various emerging technologies in order to provide at-home care.

In addition to such innovations as talking walking frames and dispensing coffee tables, the study suggests: the use of robo-pets that could offer companionship, and double up as fire, gas and intruder detectors; special exoskeleton suits that could be worn by the infirm to help them to keep mobile; and kitchen worktop and fridge screens to monitor larder contents, suggest recipes and produce automatic shopping lists.

Dr Kevin Doughty, of the JRF Centre for Usable Home Technology at the University of York, said councils are now faced with the challenge of planning to exploit emerging technologies.

Read more about emerging technologies for patient care here