Patient Portals – Not Just For Big City Practices
Clinical Decision Support not Just for Clinicians?
Data-Backed Decisions in the PICU

News & Updates

Reciprocal Labs Corporation, makers of Asthmapolis, raised $6.9 million in Series A funding from Social+Capital Partnership.

Caradigm and Orion Health partnered to integrate Orion’s Health Information Exchange capabilities into Caradigm’s Intelligence Platform. This big data play will likely spur development of new applications for Caradigm in the realms of decision support, quality improvement and metrics, and population health management.

Mood Watch, a new cross-platform mobile health app for daily mood tracking, made its debut in the App Store and Android Marketplace ($0.99). Mood Watch is endorsed by the International Bipolar Foundation, and was developed by a bipolar 1 patient.

The Centers for Medicare & Medicaid Services launched an online dashboard that gives researchers access to data on Medicare patients with more than one chronic condition. The dashboard targets the Affordable Care Act’s goals for health promotion and the prevention and management of multiple chronic conditions.

Aetna has completed the sale of its Missouri Medicaid business, Missouri Care, to WellCare Health Plans, Inc. The sale is in anticipation of Aetna’s acquisition of Coventry Health Care, Inc., which operates a separate Missouri Medicaid plan.

The Empowered Patient Coalition, a non profit group for patient awareness, launched a web application called Empowered Patient Decision Support. It gathers information through a series of questions, and produces a report of suitable suggestions and guidelines for the patients.

Scientists at the Swiss Federal Institute of Technology (EPFL) developed a tiny, portable personal blood testing device. The device, implanted under human skin, can send data to the doctor’s computer using a mobile phone network.

Cigna and Northwest Physicians Network, an independent physician association, launched a collaborative accountable care initiative to improve patient access to health care, enhance care coordination, and increase affordability.

ZirMed, a SaaS provider, launched a new product called Patient Estimation Solution. This web-based application allows provider organizations to accurately determine a patient’s financial responsibility prior to providing service or care.

Healthbox Reveals the 10 Members of Its Second Boston Class

Healthbox along with lead partner Blue Cross Blue Shield of Massachusetts (BCBSMA) officially started its second accelerator program in Boston today. It named 10 startups that have already begun participation in its 14-week long program. The companies just completed a two-week bootcamp designed to brief them on the state of the industry and to help them improve their business models.

“The boot camp helps our companies think carefully about how to both approach the overall accelerator experience, refining their value proposition to the marketplace,” CEO of Healthbox Nina Nashif said in a statement.

Healthbox, which also runs programs in Chicago and London, graduated its first Boston class last November. Like those members, the ones in this group receive $50,000 in funding, office space, and mentorship. In exchange for these benefits, startups give the accelerator 7% equity in return.

Health care startups working in Massachusetts, especially those working with BCBSMA, have a particularly unique opportunity. Three years ago BCBSMA started offering providers a payment model that works a lot like the models found in Accountable Care Organizations, according to Washington Post’s Sarah Kliff. A Health Affairs paper showed that the payment model was associated with lower health care costs and better quality of care. Through working with BCBSMA, Healthbox startups should get a very up close and personal chance to think about how their products will work in this new and very experimental model.

From the press release, Healthbox’s 10 new companies are:

  • 3Derm Systems offers a low-cost skin monitoring solution allowing patients to take two-and three-dimensional images of concerning lesions at home before being digitally reviewed by a dermatologist.

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Notre Dame Researchers Develop iPad-Based Concussion Diagnostic Tool

Fans of contact sports have witnessed a good amount of gruesome injuries. But as spectators know, one injury with maybe the most frightening consequences takes place below the surface.

Concussions aren’t always easy to recognize. Many contact sports players will say that they’ve officially been diagnosed with a concussion several times, but have likely suffered undiagnosed ones as well.

Symptoms of traumatic brain injury (TBI) can include headaches, depression and loss of memory, but experts believe there are other severe effects that aren’t well understood yet. Last year the National Football League provided $30 million to the Foundation for the National Institutes of Health to advance the understanding of brain injuries.

After a concussion, it’s important for athletes to stay off the field to keep from aggravating the injury. However, Christian Poellabauer, associate professor of computer science and engineering at Notre Dame, said that almost 90% of concussions go unrecognized.

Poellabauer along with a team of Notre Dame students developed a tablet-based application to detect TBI soon after it occurs. A user takes an assessment before and after a game or match. Looking for indicators of brain injury like distorted vowels, hyper nasality and imprecise consonants, the program compares the two sets of results. The app is meant to be a first stop for athletes. If there is any indication of concussion they’re referred to a physician. Poellabauer explains more in the video above.

N.C. Introduces a Bill to Use Its HIE to Increase Price Transparency

The North Carolina state senate introduced a bill last week that would require hospitals to publish prices on their web sites for the 50 most common procedures offered. In addition the bill would have every hospital post its charity care policy online.

Health care prices are difficult to report, as the same procedure can cost different amounts for different people depending on their payer. To account for those differences, starting Jan. 1, 2014, hospitals would need to report prices charged for uninsured patients, Medicare and Medicaid patients, and prices for those covered by the state’s five largest health insurers.

If the bill called “HealthCare Cost Reduction & Transparency” passes, information will be made available on the North Carolina Health Information Exchange web site. The senators who introduced the bill aim to make prices transparent to the general public. As for making charity care information available — it would be posted on the hospital’s webpage — their goal is to make sure that charity care doesn’t go underutilized.

Though increased transparency doesn’t hurt patients, it remains to be seen if it will benefit them the way that many hope. An argument for positing prices online is that it will give consumers an opportunity to shop for health care, something they can’t do now with the lack of information on prices. Making prices easily comparable puts hospitals in competition with one another, and a competitive market can result in lower prices.

However this bill is focused on acute care, and it’s easy to image a few ways that the competitive market theory won’t work in this case. First, in emergency situations patients can’t take the time to shop for care. Second, though new consumer-centered health plans are meant to encourage patients to pay close attention to health care prices, often this only works when patients shop for low-cost procedures.

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Patient Portals – Not Just For Big City Practices

While practices in metropolitan areas tend to adopt EHR systems at a more rapid rate, it’s important to acknowledge that implementing an efficient, customizable system can be done by practices of any size and in any part of the country.  In fact, data show that patient portals are especially critical to practices in rural areas for a number of reasons including improving communications and increasing convenience for patients who may live long distances from the physician’s office.  Of course the Stage 2 objectives of Meaningful Use, focusing on online patient portals and health information exchange, also mean that portals will now play a more significant role for all practices looking to receive incentives from this government program.

Implementing a patient portal in any area can be a challenge, but especially so in some rural locations. One of the top issues to consider when preparing to implement a patient portal, particularly in a rural area, is initially considering the level and quality of Internet connectivity in the area.  Additionally, in order for the system to be effective, patients should have personal email addresses, and it is imperative to educate the patients about the benefits by marketing the portal properly before its actual launch.

There is no arguing the convenience of a patient portal and in many cases, usage can become a family affair. First and foremost, the portal provides patients with first-hand, convenient access to all of their own medical records. They are able to take the reigns of their own health care management and access what they want, when they want from the comfort of their own home. Taking it one step further, a patient portal is also extremely beneficial if a patient’s care has been placed in the hands of a spouse, child or other family member. Via the portal, the third-party caretaker can access all of the patient’s records and results and truly manage their relative’s progress remotely and on their schedule. When used properly, a portal can allow a caregiver to schedule follow-up appointments, request refills, receive test results, track patient conditions and get answers to medication-related questions.

Additionally, if patients wish to send specific monitoring information from devices, such as blood sugar levels or blood pressures, they can do so via the portal and have that data become part of their electronic medical record.  This type of access is particularly useful for those with chronic conditions, such as diabetes and arthritis, that need to be monitored on an ongoing basis.

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Happtique CEO Ben Chodor on Taming the Wild West of Health Care Apps

Matthew Holt interviewed Happtique CEO Ben Chodor for at HIMSS 13 in New Orleans (March 7th, 2013).  Here Chodor explains how Happtique curated and categorized almost 20,000 healthcare apps to a quite granular level e.g., cardiac stent apps, glucose monitoring apps. And he discusses Happtique’s new app certification process. The hope is that one day when a doc prescribes a cholesterol-lowering drug, he or she will also prescribe a cholesterol-monitoring app to engage the patient and improve compliance.

Clinical Decision Support not Just for Clinicians?

Continuing on the topic of clinical decision support, (CEO of Health 2.0 Indu Subaiya hosted a related conversation on Wednesday) a session at iHT2’s Health IT Summit this week in San Francisco brought up an unusual question. Maybe it’s because of the term assigned to them, but clinical decision support tools aren’t typically discussed with respect to patients. But is there a place for them outside of the hospital?

Chief Medical Information Officer of Lucile Packard Children’s Hospital at Stanford, Christopher Longhurst, MD, said yes. He pointed to a recent meta-analysis published in BMJ that examined more than 160 trials. The purpose of the study was to compare different computerized clinical support systems and their effectiveness in terms of outcomes.

“One of the things that they published that’s never been cited before is that the systems most likely to succeed provided advice for the patients in addition to practitioners,” Longhurst said.

An example of patient clinical decision support was the delivery of reminders via Internet, mail, or phone, said the paper. While that sounds a lot like what many organizations are already doing or at least considering, patient advice falls in a different category when it’s advice to patients who are responsible for part of their own clinical care — for example, if they have to decide when to administer their own injections.

Longhurst said his hospital applied the idea of patient clinical decision support to a home management plan of care (HMPC) for asthma patients about to be discharged from the hospital. “This is something the Joint Commission regularly audits for pediatric patients. Our compliance was poor a couple of years ago,” Longhurst said, citing that 65% of patients adhered to the plan.

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News & Updates

Bina Technologies, a genomic data company, raised $6.25M in Series B financing. The round was led by Sierra Ventures. Bina released a commercial product last month to collect and process DNA data for personalized diagnosis.

ONC launched a website to gather public input on Consumer eHealth as part of the Federal Health IT Strategic Plan. The Planning Room, launched in collaboration with Cornell University, is open from March 25 to May 9.

Bucknell University students developed an app called Heal Thy Tendon. The app will help doctors to diagnose ankle and foot ailments, provide information and instructions to patients of orthopedics, and share information with other orthopedics professionals.

Health Tech Hatch,  a crowd-funding and beta testing resource, is one of the 48 innovators debuting in The Hive at TEDMED 2013. The Hive, in association with StartUp Health, is an informal social environment for start-ups, incubators/accelerators, government-run challenges, academically-led programs and labs run by Fortune 500 companies.

Medicare beneficiaries across 36 states and territories will lose telehealth benefits, primarily the option to receive healthcare services via videoconferencing. The change is a result of updated federal delineations of Standards Metropolitan Statistical Areas (SMSAs).

SoloHealth and Safeway signed a deal to install the SoloHealth Station kiosk in almost 700 Safeway stores nationwide. Health 2.0 previously reported on both Safeway’s original partnership with SoloHealth in early 2011 and a similar deal between SoloHealth and Walmart.

KLAS released a study on the clinical usability of leading EHRs. In the study of 128 physicians, KLAS found that no vendor scored above a four (on a scale from one to five) in clinical usability.

The Jawbone Up wristband launched in Europe. In addition to the European launch, the lifestyle tracker is now also available for Android users.

Mayo Clinic and drchrono agreed to provide patient-specific educational resources to physicians using the drchrono EHR platform. The drchrono EHR platform also features a smart patient education notification list, which can be digitally distributed to patients.

A review published in The Chochrane Library found self-managed online interventions to be ineffective for diabetics. Using data from 16 trials involving 3,578 type 2 diabetics who used cell phones or computers as part of the self-management of their diabetes, the researchers found the interventions safe, but with limited positive effects.

Health 2.0 Show Conversations: Data-Backed Decisions in the PICU

In case you missed it, you can now watch the March Health 2.0 Show below and on Health 2.0 TV. Health 2.0 CEO Indu Subaiya on Wednesday hosted talks with two guests, David Kale and DJ Patil, about their respective data science projects. Patil’s appearance on the Big Data-themed show was particularly fitting since he, along with Jeff Hammerbacher, coined the term “data scientist.” Patil is now a data scientist in residence at Greylock Partners, a venture capital firm.

DJ Patil on delivering information to the user 

Patil used the term to describe what he was doing at the time while working at LinkedIn. “We were trying to say, what is the new way you can take data and make it into a user-facing product?” he told the Phenomlist. LinkedIn users today see the results of Patil’s then-vision. Upon signing into their homepage they are now served up content like “people you may know” and LinkedIn’s recommended daily news.

Data science is a combination of many fields including math, statistics, pattern recognition, high performance computing and uncertainty modeling. The key is that all of these data operations result in a product. A good product is one that the user has no idea how much brain and computing power went into its creation.

“One of the earliest models of thinking about data, and probably the most sophisticated data product that I think we have is weather forecasting,” Patil said on the Health 2.0 Show. Every day millions of people base decisions about what coat they will wear, whether or not to take an umbrella, and even upcoming weekend plans all on one little icon.

However, a whole lot of work went into creating that icon. Weather forecasts involve information from satellites, different kinds of sensors, computer models and human interpretation. The aim is to translate all of the data into a form in which it is useful. “And you’ve got to do it fast because if you predict tomorrow’s weather two days from now that’s not really helpful,” Patil said.

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Doctors Using drchrono Now Have Access to Mayo Clinic’s Entire Patient Education Library

In terms of finding its match in an electronic health record vendor, that ship sailed long ago for Mayo Clinic. But that doesn’t mean it can’t still speak to other vendors, especially startups.

On a trip to Silicon Valley to reach out to local companies here, Mayo met with drchrono, creator of the free iPad-based EHR. The resulting partnership led Mayo to supply drchrono with the materials it needed for its latest project.

Physicians can now use drchrono to offer their patients medical education resources, all authored by Mayo Clinic. This includes more than 2,600 documents and 300 videos that cover everything from general wellness to specific diseases. Before Mayo made this material available outside of its facilities, it was mainly delivered to patients in paper form, or they could watch videos on site.

Drchrono took all of those files and digitized them so that patients can view them in the waiting room on an iPad as well as at home on their patient portal. Drchrono has a personal health record manager called onpatient, which connects to physicians’ drchrono EHRs. Through onpatient, users can view their doctor’s recommended reading, and doctors can also check whether their patients viewed the materials.

The idea is to help physicians continue to go completely paperless, and more importantly, to help them fulfill a measure of Meaningful Use that is often an afterthought. A Stage 1 Meaningful Use requirement calls for doctors to provide 10% of their unique patients with education resources.

“They may not even be thinking about patient education now, but it’s just one of these second order problems that comes up when doctors are actually adopting EHRs,” CEO of drchrono Michael Nusimow said.

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