Changes in Health IT Industries/Internet Addiction

Health IT industries is rapidly evolving into all areas of the Health Care disciplines. I was around when Hospital registration area, Laboratory department and Pharmacy were the only places that utilized IT equipment’s for their daily operations.

The next was the birth of the old Hospital Information systems with nursing applications and the computer on wheels called COW that created ergonomics challenges for nurses and their employers. Now we have hand held devices, smart phones, picture archiving  computer systems (PACS) that can inter-phase with other Hospital systems and able to transmit images to the point of service. Video conferencing are also becoming more prominent in the provision of care.

Internet Addition:

American Heritage College Dictionary defines Addict as: “To devote or give one-self habitually or compulsively” I think the use of the word “Addiction” as it relate to internet use is extreme. People may be addicted to the products of the internet like in gambling, pornography and decide to use the internet as a mode of reaching that addiction. I believe that the internet has served us well in this information age and there is a growing dependence on it use to meet the needs of all consumers. I will not call the excessive use of it as an addiction.

My online experience on the social networking site is limited to the use of e-mail. The use of the e-mail is truly a quick and convenient way to stay in touch. My face book account was as a result of this class. I have used it four times since then to accept few friends and I have also politely decline request for friendship. It is too intrusive for my liking. I had have problem in getting into second life but as of today, the problem is resolved. A technical expert spent about an hour correcting all the wrong in my computer. I will soon be exploring that site to experience the second life phenomenon. 

Quality of Online Communication

 It was interesting seeing the diverse topics covered in this course by fellow classmates. This truly shows that Health Informatics Programs has the ability to attract eclectic students. The quality of online communication depends on the internet sites and the reputation they have established, the biography of the bloggers, the target audience and the individuals or organizations. Mayo clinic websites for instance may only post articles that meet certain standards as oppose to “YOYO Club”.

Classmate’s blog sites address issues relevant to this class and some includes their occupation related information. They were all professionally done and directed towards particular groups.

 Internet as a public domain is open to anyone with access to a computer. It does not matter if they have good intent or not, educated or uneducated. As a result, the quality of online communication depends on what we look for. I have seen some blogs that I had difficulty understanding what they were attempting to communicate or sell. So the quality of online communication has a broad spectrum therefore the ability to screen sites with an established criteria is the key.     

E-PATIENT AS A WAY OF THE FUTURE

The growth in the Health Care Information Technology and the myriad of online and mobile tools is enabling patients to engage in their health in ways not previously feasible. The development of the e-mail, video conferencing, smart phones and electronic health records has enhanced the quality of communication between physicians and patients. The provision of quality health care depends on the clinician’s ability to adequately communicate diagnosis and treatment regimens, as well as provide appropriate health education information. There is a common belief that e-patients are a minority of motivated people but do not represent the bulk of the patients being attended.

A recent report by the PEW Research Center Internet Project describes the rise of the e-patient. A rapidly growing segment of the population is using the internet and other e-tools to access their health information; 61% of the total population and 83% of the online population use the internet for querying about health information. It was said to be widespread across genders and ethnicities; 64% of men and 57% of women; 65% of white; 51% of black and 44% of Hispanics use the internet this way. There is a skewing towards upscale and educated users and towards the parents of young children. Over the past few years, e-patients have become high-speed using broadband 88% of the time and mobile using wireless 89% of the time. E-patients are also more likely to use social media and build online networks of “patients like me” to discuss the health conditions.

The poll conducted by GFK Roper said: Three in five American with chronic disease say using a Home Medical Device would improve their Health. About half of Americans currently live with at least one chronic condition and more than ninety percent of Americans age 65 or older are living with some form of chronic illness according to the Center for Disease Control (2010). There is also a growing interest in clinicians monitoring patient’s health using remote medical devices for patients with or without chronic conditions.

Home medical devices and e-patients can save the Health Care System money and also enable patients to live more independently. It will also create green health by preventing what will have be pollution resulting from transportation between clinician’s offices and medical centers. Electronic medical records system will serve as a conduit linking these devices to patients and clinicians.

Traditionally, face to face and telephone communications have been the primary mechanisms for communicating health information. The emergence of new technology, internet applications, smart phone applications, social network for communications among physicians and health care organizations and between clinicians and patients continue to be another viable avenue for patient communication. E-mails have taken on increased significance as a mode of communication that is readily available to patients and health care professionals.

The use of e-mail by clinicians allow for follow-up in patients care and clarification of advice provided in professional office settings. E-mail creates a written record that removes doubt as to what information was conveyed. E-mail is especially useful for information the patient would have to commit to writing if it were given verbally; examples include test results with interpretations and advice; instructions on how to take medications or apply dressings; and pre and post-operative instructions. Some frequently used educational handouts can be ported to an e-mailer template or formatted for the clinician’s home page or the World Wide Web.

E-mail messages can also embed links to educational materials and other resources on the practice’s web site or on external sites. In some electronic mail applications, clicking on a “Live” universal resource locator link inside a message launches a web browser and takes the user directly to the indicated resource.

With the continued increased usage of computers and the internet by individuals; e-mail can be a valid, simple convenient and inexpensive mechanism for communication. It can aid the health care delivery process by allowing written follow up instructions, test results and dissemination of educational materials for patients as well as a means for patients to easily reach their physicians on routine health matters. At the same time, issues of privacy, confidentiality and security must be addressed to ensure the efficacy and effectiveness of e-mail.

As consumers, e-patients have used the internet to find out about the health delivery system as purchasers of service; 47% have looked up information about doctors, 38% have gotten information about hospital; 33% about how to lose weight; 27% about health insurance; 12% about how to stay healthy during oversea travel (Healthcareitnews, 2010).

Clearly, as technology has evolved and delivered fast, meaningful, mobile and low cost tools, patients are becoming “e-patient” they are engaging the health care delivery establishment in a new way, in what can be described as participatory medicine. Is there a direction towards which this development of e-patients and participatory medicine is heading? Are there platforms that are in a position to enable this direction? Patients, as consumers are gathering information themselves over the internet sometimes from trusted sources and sometimes from questionable sources and are forming communities among themselves in order to find meaning, support and experience in making health care decisions. Engagement with physicians and other health care providers is the logical next step in this evolution. Health professional when actively engaged in the networks that patients are creating anyway, can provide context and meaning.

Many people believe that this approach offer a potential way to save health care cost, protect the environment, and allow people to stay out of Hospitals and Nursing Homes. To drive the point of e-patients home as having the potential to thrive in the very near future, for few weeks now, I have been having problem with my left knee. I took few Motrin tablets and thought the pain will go away. When I did not get much relief, I called to schedule an appointment to see my physician at one of the Kaiser medical offices in my area. After an examination by my physician, he ordered a pain medication, some lab work and an x-ray. Because my lab work was done separately, I had to make another trip to the clinic just to review my lab result.

In the conversation that follows the meeting, the physician spends some time to talk about the benefit of establishing an account in their secured web site. I should have been able to log on and view my lab work result rather than leaving work early to drive to the clinic to see my result. We also talked about using that site to ask for clarification, refill prescription, and have the drug delivered to my home or schedule a routine appointment.

I believe that e-patients are the wave of the future. The consumer friendly Health Internet, which is still a dream in practicality is something that will be achieved fully in the very near future, 

References

Guideline for physician-patient electronic communications: www.ama-  assn.org/…guidelines-physician

Home monitoring devices may ease world health burden: www.reuters.com

Survey finds high interest in home medical devices:           www.healthcareitnews.com

Verizon to assist health information exchange: www.govhealthit.com

Yellowlees, P.M. (2008). Your health in the information age: how you and your doctor can use internet to work together. I universe, Bloomington, In.

Second Life for Health Care

Second Life for Health Care

I am a little disappointed that I have not had the opportunity to truly experiment Second Life. I created an account and worked with Ben last Wednesday for about an hour after all personal attempts failed. For some ungodly reason, I am still not able to use Second Life. I have invited a digital native to my house tomorrow to assist me in getting my computer to obey and always listen to and follow my hearts desires. I am also looking forward to the day I will be able to change my status from digital immigrant to a native.

            However, I reviewed the videos posted by Ben and did some reading on Second Life and I believe I can confidently write commentary on the uses of Second Life in doctor-patient relationships.

            As every consumer of health care continues to look at the cost of health care as a huge burden, while organizations are looking at innovative ways to make it more cost effective and efficient. Also the continued improvements in information technology hardware and software have drawn the attention of health care leaders.

            Second Life, which is a virtual reality environment, has a place in cost effectiveness and efficiency in the provision of health care in the near future. According to the data provided in Dr. Yellowlees lectures, Second Life currently has 10 million registered users, 150-200,000 users online at any given time, young, well off, males. As more users become familiar with the site and its potentials, it may develop to level similar to how video conferencing and e-mail is used in doctor-patient relationships today. In my opinion, I think the true potential will be in the area of education and awareness, support, training and promotion of health services.

           

            Education and Awareness: Second Life will be good in this environment because a clinician can actually fine-tune their clinical skills without fear of causing any bodily damage or putting someone in a life threatening situation in real life. After proficiency in this environment, the skills can be transferred to fist life to benefit real life environments; people are most comfortable with fantasy environment in tuning up their skills because of the no risk of harming anyone and anonymity encourages bold and confident behavior, the awareness of drills like in disaster clinic for bio-terrorism enable people to practice what other wise would have been in-practical in real life environments.

            Support: Second Life is a good environment to have support groups in diseases that are not socially acceptable conditions. People will be more comfortable and open in the discussion of their issues due to the anonymity.

Training and Promotion of health Services: This is an environment that can support training and promotion of health care services. Health training requires a lot of practice to develop proficiencies. Simulation of real life can be conducted in this environment and once health professionals become comfortable, that skill can be transferred to real life environments. Health promotion could be encouraged by having consumers of health care to do a dry run on any situation they may encounter in real life, example: Consumers preparing for physical therapy can to go through the processes of the projected his/her intended services to measure what could be the outcome.

Having written all of this about Second Life, I think it is not ready for prime time yet. First it has to work on simplification to make it easier for digital immigrants to navigate. Second, it should continue to work on creating awareness of its existence to cover a diversified group of potential users and to target university health service programs so that the site could be a place of choice for clinical rotations and health care research studies.

IT Aid to Largest Medical Fraud Sting in History

A few months ago, Medicare fraud was one of the topics discussed on CBS’s 60 Minutes. It was stated that the government may have lost sixty billion dollars to fraudulent activities within the Medicare system.

The fraud scheme as presented by the show 60 Minutes reported that various people or their agents were submitting fraudulent bills for medically unnecessary treatments or treatments that were never actually performed. These criminals were able to collect claims easily because the government did not have the ability to verify the validity of a claim before making payments that had to be paid within thirty days.

I have always wondered how people could defraud the government of the United States for 60 billion dollars with relative ease over time. The most powerful nation in the world has become a sucker to organized crime who operates across the US with impunity.

In the healthcare IT news, there was an article on October 15, 2010 stating, “IT Aid to Largest Medicare Fraud in History.” The article started by stating that information Technology and data mining capabilities had a role in dismantling what authorities are calling the largest Medicare fraud scheme ever, involving seventy-three members and associates of organized crime and more than 163 million dollars in fraudulent billing. The organized crime enterprise was charged October 13^th, 2010 in five judicial districts in unsealed indictments.

It was described that these criminals allegedly stole the identities of doctors and thousands of Medicare beneficiaries and operated at least 118 phony clinics in twenty-five states.

This bust was made possible with the collaborative efforts of various govrnment organizations through investments in modern technology. This new technology has the ability to compare in a matter of days, analysis of electronic evidence that previously took months to analyze using traditional investigative tools. It also improves data and information sharing between the Center for Medicare and Medicaid Services (CMS) and law enforcement to identify patterns that lead to fraud. This interagency effort is known as the Fraud Prevention and Enforcement Action Team (HEAT). It is tasked with combating Medicare fraud by building upon and strengthening existing programs combating fraud, as well as investing in new resources and technology to prevent waste and abuse.

What I may not understand is why it took the loss of about 50 billion dollars to alert the government. There were series of providers and Medicare beneficiaries who, for years, have complained to the government items that showed on their statements were phony and yet no one within the agency took their complaints seriously. It will have taken a very small fraction of that stolen 50 billion dollars to develop an IT system that would have put these criminals in check long ago. This is definitely another case against the bureaucratic process. 

           

Introduction

This my very first blog and I created it for the health informatics class - The internet and the future of patient care. I am hoping this class will fast forward me into the future so that I can acquire some of the characteristics of a futurist. This is big stuff considering my background. I was born and grew up in West African coast. I migrated to Houston, Texas in 1981 and to Oakland, California in 1986. Since then, I have lived in Hayward, Sacramento and now in Visalia. I have worked at Highland General Hospital, UCD MC and Fresno community Regional Medical Center before going into correctional health.