MyChart: One Toronto hospital’s e-health triumph – The Globe and Mail

Good example from Toronto’s Sunnybrook Hospital of a successful and running patient portal, with 20,000 users. Would love to have this rather than my own cobbled together ‘system’. Quote:

Dr. Calvin Law, a cancer surgeon at Sunnybrook, noted there were initially some concerns that direct access to medical records would cause confusion or increase anxiety among patients. Instead, MyChart has led to better-informed patients, he said.

Doctors normally have a limited amount time to spend with each patient. During these relatively brief appointments, patients may not comprehend or remember everything they are told. By being able to review their doctor’s notes, patients gain a greater understanding of their condition. And if a doctor’s notes contain medical terminology or information that patients don’t understand, they can raise questions at their next appointment.

“It empowers the patients so much more – like we are in it together. And it is a whole new way of doing medicine,” said Law.

MyChart: One Toronto hospital’s e-health triumph – The Globe and Mail.

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How Big Data Became So Big – Unboxed – NYTimes.com

How big data became the new marketing term for businesses, in contrast to some of the dryer terminology like ‘data mining’, ‘business intelligence’ and ‘data analytics’. Quote:

IT may seem marketing gold, but Big Data also carries a darker connotation, as a linguistic cousin to the likes of Big Brother, Big Oil and Big Government.

“If only inadvertently, it does have a sinister flavor to it,” says Fred R. Shapiro, editor of the Yale Book of Quotations.

Big Data’s enthusiasts say the rewards far outweigh the risks. Still, smart technologies that promise to observe, record and make inferences about human behavior as never before should prompt some second thoughts — both from the people building those technologies and from the people using them.

How Big Data Became So Big – Unboxed – NYTimes.com.

When Medical Informatics Clashes With Medical Culture – Informationweek

Notes how the lack of information on costs hampers more informed choices by doctors and patients. A number of articles have talked about the particularly opaque nature of costing and billing in the US (although I expect that the HMOs have fairly good data and reimbursement schedules), as do the more public universal systems in other countries. Quote:

Many physicians would argue that ignoring these more remote diagnoses means putting costs ahead of patients’ welfare, and that’s simply unethical. But Rosenbaum and Lamas point out in their recent NEJM editorial, Cents and Sensitivity–Teaching Physicians to Think about Costs, “Considering cost serves not only the equitable distribution of finite services but also the real interests of individual patients. Medical bills, after all, are among the leading causes of personal bankruptcy.”

Those bills would be significantly lower if physicians stopped ordering unnecessary procedures. And there’s now solid evidence to show that some routine diagnostic and screening tests really are a waste of money.

Among the worst offenders: screening EKGs, chest X-rays before outpatient surgery, and CT scans or MRIs after a patient faints. Unnecessary tests have become so prevalent that nine major medical organizations have launched “Choosing Wisely” campaigns to educate clinicians and the public about wasteful testing.

When Medical Informatics Clashes With Medical Culture – Healthcare – Electronic Medical Records – Informationweek.

Better medicine, brought to you by big data — Cloud Computing News

Some concrete examples of how ‘big data’ is improving medicine and healthcare:

1. Genomics
2. Business intelligence for doctors to analyse hospital-wide data
3. Semantic search to improve search results (more plain language search)
4. Hadoop (?) for everything – identifying unsuspected adverse side effects from multi-drug combinations, or analysing medical images
5. IMB’s Watson diagnostic tool
6. Getting ahead of disease by identifying predictors
7. Data scientist in residence
8. Crowdsourced science – see PatientsLikeMe website

Worth a quick read.

Better medicine, brought to you by big data — Cloud Computing News.

X-rays and iPads: The network healthcare evolution | Ars Technica

An overview piece on some approaches to more aggressive use of technology to:

• Monitor patients’ health more proactively with networked devices, ranging from wirelessly networked medicine bottle lids to worn or embedded sensors that report back on vital signs;
• Coordinate care with the help of analytic tools in the cloud and a wealth of individual and collective patient data; and
• Connect physicians directly with patients over PCs or mobile devices for between-appointment follow-ups.

And of course the easy, an obvious applications for iPads (imaging, not just x-rays), particularly with the latest model and its HD display.

And the usual obstacles and challenges to making this happen, ranging from privacy considerations to compensation.

X-rays and iPads: The network healthcare evolution | Ars Technica.

The online presence of health information empowers patients

One of the more optimistic, almost utopian version of how online information and related eHealth applications will improve healthcare outcomes at reduced cost. One of the bigger challenges is figuring out where can online activity appropriately replace traditional contact, with increased efficiencies, and where does it simply increase overall demand for healthcare, at increased cost and time, as well as the investment in infrastructure required to provide an effective online presence.

The ‘baby steps’ that I see with my family doctor (office completely electronic, all paper scans into the system), at the Blood and Marrow Transplant clinic (good EHR for all hospital related records, but hopeless paper-based notation of clinic visits, and openness to email communications – which I try to use sparingly), and some of the new monitoring devices that allow us, not just the ‘quants’, to more closely monitor our health, will likely be the way that change occurs incrementally.

The online presence of health information empowers patients.

The Prognosis for Medical Innovation – NYTimes.com

A good short piece on innovation in healthcare, and how sometimes the big, shiny and new can be overshadowed by smaller, incremental changes that deliver better outcomes (e.g., checklists, smartphone home monitoring applications, and progress towards electronic health records). The key point is to have good data to know which new technology and/or procedures result in greater improvement in outcomes, to assist investment and use decisions.

The Prognosis for Medical Innovation – NYTimes.com.