Good Blog about Google Health

I have been playing around a bit on Google Health and have some issues, which I will discuss in a later post. I found this post from FutureHIT and thought it was a good summation of how GH might be used by all in the healthcare spectrum.

Hard Definitions for EMR, EHR and PHR

Hat tip to Ted Eytan for this information from Healthcare Informatics.

To me, PHR has always been the Revolution Health and now Google model of a Personal Health Record. The confusion between the EMR, and EHR is now clear.

The Chicago-based National Alliance for Health Information Technology (Alliance) released its final report, “Defining Key Health Information Technology Terms,” defining six important HIT terms.

The definitions, which will be presented to the Washington-based American Health Information Community (AHIC) on June 3 for final approval, are:

· Electronic Medical Record

An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.

· Electronic Health Record

An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.

· Personal Health Record

An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.

· Health Information Exchange Health Information Organization

The electronic movement of health-related information among organizations according to nationally recognized standards.

· Regional Health Information Organization

An organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards. A health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community.

Cincinnati Children's Hospital Texting For Health

There have been a couple of articles written about the Cincinnati Children's Hospital text messaging for medical adherence program.

Here is one from the Cincinnati Enquirer.

And the Yahoo! pick-up of Lauran Neergaard's AP article.

Nothing really to comment on, except that it is great to see other's catching on to what we have been doing for three years!

A Case of Medication Non-adherence

Is this an acceptable case of medication non-adherence or just my own lack of planning?  Of course there is no acceptable reason for medication adherence - if you want to get better, you take your medications.  Plain and simple.  

I lived through the agonizing pain of flushing with 1000 mg of Niaspan, including the spaciness, and insomnia due to the nightmares of my flesh burning.  The cost of switching to a HSA with three medications for me, two for my wife and two for my son - luckily back to a regular payor.  And created Intelecare reminders to help me remember to take my medications (one trick I like is to keep some meds at work, just in case).

So here is my case:  My wife went into labor with our second son two weeks early, at 2 am on a Saturday night.  She woke me at 4 am and told me that we had to leave for the hospital immediately.  I quickly packed a toilet kit for us both (including my meds but not hers) and some clothes, then went to the hospital; she gave birth at 5:45 am.  Our medication schedules were not top of mind.  Luckily for her, the nurses knew she was on medication, and the attending physician prescribed her a two day supply.

Once we settled into our room at 8 am or so, I did not unpack our bags.  We napped until 1:30 pm and then started accepting visitors.  I went home at 9 pm or so with our 1st son,  and realized I left all my meds at the hospital.  Thus, I ended the day non-adherent to my two morning, and two nighttime medications.  

The next day was a rush of our nanny starting, buying items for the baby (car seat, diapers, new bottles, etc...), and fielding calls.  I made it to the hospital around 1:30 for lunch, but the bag I packed for Courtenay still was not open.  I had more errands to run, then returned around 7 for dinner.  I finally got my medications, and took that nights does when I went to bed.

The next morning (Tuesday), I only had two more Tricor, so I called in a refill, but was unable to pick it up until yesterday (8 days late).  Luckily I had my extra stash in my office.

Now these medications I take are for asymptomatic conditions - high cholesterol, and high triglycerides - but what if they were for asthma, diabetes, or high blood pressure and I suffered an attack?  

Life sometimes gets in the way of staying adherent to your medication schedule.  I usually operate at 100% adherent to my daily schedule - whether the morning disbursement is at 7:30 am when I brush my teeth or 9 am when I get into the office.  My test results were too positive not to continue taking my meds.  These drugs lowered all of my levels, and put me in a safe zone - although I still need to go down a few points, and now my sugar levels are higher which is characteristic of one of my meds.

I gave myself a pass for Monday and Tuesday of last week.  But my overall adherence for the month dropped significantly.  Maybe I should keep an extra supply in my car as well?

Disease Management Colloquium in Philadelphia - Day 1

I attended the DM Colloquium hosted by Jefferson Medical College in Philadelphia at the beginning of the week.  I wanted to blog from the conference, but I didn't want to be rude to the presenters, and I couldn't get the T-Mobile Hotspot to work outside of my room at the Hyatt.

I arrived on Monday and saw Stephen C. Schoenbaum, MD, MPH, Executive Vice President for Programs, The Commonwealth Fund give a keynote. You can view his presentation here.

One of the problems attending these conferences is that I do not always learn that much as one of my roles with Intelecare is market research.   I know America spends the most on healthcare (almost double) of any other modern country, and has the worst system but I did not know that 51% of patients in the US with a chronic condition do not have a "Medical Home".   Meaning no PCP.

I didn't have a PCP when I moved to Connecticut in 2001, and did not get one until 3 months before my son was born in 2007 - but I was still a little surprised by this number.  I know a lot of patients without insurance use ERs as their primary care, but 51% just struck me as bigger than I thought for chronic conditions.

Dr. Schoenbaum presented some of the CWF findings from a few reports and well as options for "savings" in the healthcare system.  Overall a great presentation for the crowd.

Next up was Matthew Holt from the Health 2.0 Conference.  He (obviously) spoke about how Health 2.0 companies can possibly help disease management companies and healthcare in general (his presentation has not been uploaded to the DMC site yet). I have seen Matt present before, and seen some of his presentations online.  Always entertaining and informative.

He gave an overview of the Web 2.0 to Health 2.0 - Search, Social Networks and Tools.  And referred to the educated patient as one taking control of their own healthcare.

Some great takeaways:

High deductible health plans = pay more and get less.

Netherlands and Sweden have 90% of patients on EMRs - US has only 17%.

53% of adults were "cybercondriacs" in 2006.

Finished with new definition:  Patient Guided Care as opposed to Patient Centric Healthcare.

It was a great first day to ease into things.  Unfortunately my favorite Philly restaurant, Vetri, is closed on Mondays, but what are you going to do?