Should Wearables Data Live In Your Electronic Medical Record?



Subscribe-to-our-NewsletterNOVEMBER 29, 2014 – The great promise of wearables for medicine includes the opportunity for health measurement to participate more naturally in the flow of our lives, and provide a richer and more nuanced assessment of phenotype than that offered by the traditional labs and blood pressure assessments now found in our medical record.  Health, as we appreciate, exists outside the four walls of a clinical or hospital, and wearables (as now championed by AppleGoogle, and others) would seem to offer an obvious vehicle to mediate our increasingly expansive perspective.

The big data vision here, of course, would be to develop an integrated database that includes genomic data, traditional EMR/clinical data, and wearable data, with the idea that these should provide the basis for more precise understanding of patients and disease, and provide more granular insight into effective interventions.  This has been…

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Direct primary care emerges in post-reform world.


If American primary care is broken, direct primary care is a crucial strategy for restoring its integrity.

By Ryan Liabenow

DPC Consumer Guide cover_20152DECEMBER 16, 2014 –Direct primary care (DPC) is a disruptive concept in which payments for basic healthcare remain entirely outside the health insurance networks. But the efficiency of this delivery model makes it an appealing choice for self-funded health plans, while also yielding improvements in treatment outcomes and provider experience.

How health plans benefit

Self-insured businesses need to take advantage of every avenue for cost-savings, and statistics repeatedly demonstrate that the best return on health spending comes from increased access to primary care. As an example, Forbes profiled three self-insured employers who work with a disruptive concept (DPC) provider and have seen lower absenteeism and employee stress levels, improved employee morale, and a 10 to 40 percent drop in emergency room visits.

In just the first…

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Smooth Transitions: Integrating Into a Multispecialty EHR

Smooth Transitions: Integrating Into a Multispecialty EHR

ECG Management Consultants, Inc.

Specialists who have worked with electronic health records (EHRs) are well aware that most EHRs are designed with PCPs in mind, with minimal regard for the intricacies of subspecialty work flows.  As more and more specialists align with hospitals and health systems, integrating with multispecialty EHR systems and leveraging this technology to improve care quality and performance is critical.  Whether you’re already part of a multispecialty group, considering joining one, or evaluating a new EHR solution, you need to make sure the EHR meets your needs.

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Has your Hospital replaced error prone paper based Observation Systems with mHealth Apps?

National Institutes of Health launch video introducing mHealth: a new discipline in health research

National Institutes of Health launch video introducing mHealth: a new discipline in health research

mHealth Insight

In today’s society we are almost never without our mobile devices. We are constantly connected to one another through a vast global network of wireless signals. In the U.S. alone, there are over 285 million wireless subscribers. As technology advances, it has seamlessly integrated into our daily lives, and now, health researchers are beginning to leverage this technology to manage our health and behaviour. Wearable digital health sensors have been developed that can track everything from our heart rate and breathing pattern to our blood chemistry and hydration level and even our activity. The information collected from sensors and participant reports can be combined to infer health status, cognitions, attitudes, and mood. With help from our mobile devices, the data from these sensors can be analysed and transmitted directly to the person, family, or health professionals. And so, a new discipline in health research has been born. Mobile health…

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Optimizing Revenues With a Pediatric EHR

Optimizing Revenues With a Pediatric EHR

Healthcare IT

When I’m told of a generic Electronic Health Record (EHR) deployed at a pediatrician’s practice, the image of a small child wearing a free-size shirt comes to my mind. In simpler terms, it is too big for the child.

Similar to the oversize shirt on a six-year-old analogy, a generic EHR has been built keeping in mind the specifics for adult care. With a Pediatric EHR Software, however, vendors have incorporated the requirements of pediatricians into this specialty-specific software.

In addition to children-specific ranges, different categories such as more precise dosage scales (as children have less intake capacity than adults), growth charts and pediatric templates are also available.

Pediatric ehr (2)

Stop viewing your EHR as a government-enforced requirement and start focusing on how your practice can benefit from it. Here’s how you can do so:

Customize your templates

There are numerous customizable templates including those for abdominal pain, weight loss and…

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Mobile solutions that support our clinical (and life) workflow

Mobile solutions that support our clinical (and life) workflow

Mobile Health Matters

There are more mobile devices than there are people on the planet. Many of us look at our phones more than 70 times a day. We bring them with us everywhere we go – to the movies, to our children’s soccer games and to work.

Many of us even have work environments that allow us to ‘bring your own device.’ If that is not an option, our work devices (thankfully!) are looking more and more like our personal devices. And in healthcare, we are now successfully addressing challenges to building mobile healthcare solutions that support our natural use and knowledge of these devices in our life flow.

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Who Will Win at Population Health Management?

3M HIS Blog

Healthcare by transaction is dead. This economic model cannot be sustained. The new frontier involves aligning care providers across the continuum so they can think differently – and act differently. Successful population health management involves the strategic use of data to deliver the right care to the right population at the right time. Instead of managing the health of an individual episodically, providers will be challenged to manage the health of a group of individuals over time. The shift from volume to value requires providers to take on accountability for the total cost of care, the quality of care and the outcomes of care – rather than simply provide services when people are sick.

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Healthcare Isn’t Being Disrupted…Yet.

Healthcare Isn’t Being Disrupted…Yet.

Aaron Berdofe, MHI - Health Informatics


verb:  1. To cause disorder or turmoil in.  2. To destroy, usually temporarily, the normal continuance or unity of; to interrupt.  3. To break apart.

I know a lot of us in the Healthcare IT industry are used to filtering out buzzwords to evaluate whether something actually has value or not.  Take this buzzword heavy piece of shill  for example which is sad, but hillarious because of how earnest it is.  I can’t even type the title of “article” because my keyboard won’t take me seriously.  If I were playing drinking buzzword bingo to that piece, I would be dead drunk after the first paragraph (mostly dead).  Yet, while this is just one example of an inexhaustable supply of muckery, I have to admit, one buzzword still gets me to pause and notice just about everytime: Disruption.

The reason why this one gets me is that taken in an academic discussion…

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FORBES: Why Is Telemedicine Suddenly Hot?

FORBES: Why Is Telemedicine Suddenly Hot?


By Todd Hixon, Forbes Contributor

OCTOBER 22, 2014 – Google’sGOOGL+0.54% recent announcement that it will provide telemedicine services was the crescendo to a swelling volume of recent interest: e.g., articles in VentureBeat, U.S. News, and The Economist. Telemedicine has been around for a generation. Why is this happening now?

Subscribe-to-our-NewsletterRising use of telemedicine takes different forms. Traditionally telemedicine has played the biggest role in rural areas where visits to doctors are difficult and in consultations with specialists like radiologists and oncologists where value is created by connecting a patient to the best expert. This is expanding because broadband network coverage is improving, patients and doctors are more comfortable with computers, pressure for cost savings is increasing, and an emerging policy consensus favors telemedicine. This all makes sense. But, these forces have been at play for a decade or more and hence don’t account for the…

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Public Release of IOM Report: “Capturing Social and Behavioral Domains and Measures in Electronic Health Records”

Public Release of IOM Report: “Capturing Social and Behavioral Domains and Measures in Electronic Health Records”

The IOM Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health records will release its Phase 2 report on November 13, 2014 at 11 AM EST. This committee was asked to recommend core measures of social and behavioral domains for inclusion in all EHRs. To provide better patient care, improve population health, and enable more informative research, standardized measures of key social and behavioral determinants need to be recorded in electronic health records and made available to appropriate professionals. This committee identified a parsimonious panel of measures that is comprehensive, interoperable, and efficient.

Nancy Adler, Ph.D., and William Stead, M.D., will be presenting the specific domains and recommended measures that should be included in all EHRs. They will explain the committee’s process in selecting these domains and their measures, and they will discuss the possible future implications of incorporating these social determinants of health into electronic…

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Reducing “Excess” Readmissions to Hospitals

Reducing “Excess” Readmissions to Hospitals

Garlo Ward P.C.

Section 3025 of Obamacare penalizes hospitals for readmissions that the Central Authority deems excessive.   Those who run afoul of the edicts of the Central Authority are  penalized up to 3% for readmitting too many Medicare patients in a 30 day period.  CCHF recounts that these penalties are increasing.

In typical ham-handed fashion, the Central Authority cooks the books and skews the data:

Hospitals and other concerned parties who opposed the rules chastised the administration for:

·      Penalizing hospitals for what happens during the 30 days patients are not under hospital care.

·      Extrapolating results using medical record data from only 25 patients, potentially leading to inaccurate conclusions.

·      Not excluding from readmission review patients with “extreme conditions” such as organ transplants, end-stage renal disease, burns, psychosis and chemical dependence.

·      Not taking into account socioeconomic conditions of patients (e.g. race, geographic location, occupation, income, lifestyle, language, literacy).

·      Not distinguishing…

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Countries Spending the Most on Health Care

Countries Spending the Most on Health Care


Countries Spending the Most on Health Care

July 2, 2013 by Alexander E.M. Hess and Michael B. Sauter

health care
Source: Thinkstock

Historically, health care spending among developed nations has grown considerably each year. However, beginning in 2010, spending has flattened. Based on figures published last week by the Organization for Economic Co-operation and Development (OECD), slow growth in 2011 reflects the continued impact the global recession has had on government spending.

As of 2011, health care cost $8,508 per person in the U.S., more than $2,800 higher than the second-highest spender among developed countries. The next big spenders are countries like Norway and Swizterland, which spent more than $5,000 per person. The reasons health care costs in these countries are so high varies considerably. Based on a report published by the OECD on global health issues, 24/7 Wall St. reviewed the 10 countries that spent the most on health care per capita.

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SPECIALDOCS: Physicians at the Front Lines Increasingly Suffer from Burnout, According to New Reports

SPECIALDOCS: Physicians at the Front Lines Increasingly Suffer from Burnout, According to New Reports


By Specialdocs Consultants, Inc.

Subscribe-to-our-NewsletterOctober 24, 2014 – An article in the October 22 Chicago Tribune highlights a phenomenon physicians know all too well—burnout, a long-term reaction to stress that includes emotional exhaustion, a sense of depersonalization and a lack of a sense of personal accomplishment.  Particularly prevalent among primary care physicians, who then leave medicine, the burnout factor may worsen the current doctor shortage at the very point when many more are needed to care for aging Baby Boomers and new patients insured through the Affordable Care Act.

According to research compiled by a number of professional organizations, the problem results from challenges within the healthcare system that diminish autonomy, make it difficult to establish relationships with patients, require excessive documentation, a sense of isolation…all the factors that prompted our Special Docs physicians to make the change to concierge medicine.

While transitioning to the concierge model was not mentioned—and…

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Connected Health and Accelerating the Adoption of #mHealth

Connected Health and Accelerating the Adoption of #mHealth

Navigating Healthcare - Patient Safety and Personal Healthcare Management

I attended the Connected Healthcare Conference in San Diego yesterday Accelerate mHealth Adoption: Deliver Results through Data Driven Business Models for End-User Engagement

Never has there been so much to play for in the mobile health landscape, a revolution is just round the corner with key players from the health care and consumer markets coming together to develop the mHealth industry. This Connected Health Summit will create a bridge bringing together hospitals, clinicians, providers, payers, software and hardware innovators, consumer groups and the wireless industry.

You can find the agenda here and the organizers will be publishing the presentations – there were many interesting insights

Andrew Litt, MD (@DrAndyLitt) (Principal at Cornice Health Ventures, LLC) opened the conference with a great overview of the industry and a slew of challenges and opportunities.

He sees our industry in Phase 1 – the Capture and Digitization of records and we have…

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The Impact of ICD-10 on Reimbursement: What’s Realistic?

The Impact of ICD-10 on Reimbursement: What’s Realistic?

3M HIS Blog

HFMA Reg 2On a beautiful fall day in upstate New York, I joined a group of healthcare financial executives at the HFMA Region 2 Fall Institute. Meeting hot topics included change management, the CMS Two Midnight rule, big data, and Medicaid updates.

Attendees also learned about the impact of ICD-10 on reimbursement in my presentation “ICD-10: Determining the Realistic Reimbursement Impact on MS-DRGs and APR DRGs.” While ICD-10 may impact many areas of the revenue cycle after October 1, 2015, including the DNFB and cash flow, my presentation focused on analyzing the potential shift in reimbursement by comparing claims coded in ICD-9 and ICD-10.

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New Connected Glucometer brand launches at TechCrunch Conference

New Connected Glucometer brand launches at TechCrunch Conference

mHealth Insight

Livongo Health launched at TechCrunch Disrupt San Francisco 2014

In a striking sign of how mHealth tech is becoming of growing interest to the mainstream tech industry (and vice versa) a new glucometer for diabetics has been launched at the TechCrunch Disrupt Tech industry conference in San Franciso.

I think it’s great to see more innovators trying to innovate with M2M tech but it’s a little concerning that in the intro video founder Glen Tullman is claiming the Livongo device to be “the first FDA approved two way interactive glucometer“:

Clearly Telcare has had a device in the market that is FDA approved and has embedded mobile connectivity (enabling two way interactivity) for years – click here to read some of my thoughts on this solution – and any Doctor or Endocrinologist (the key prescribers of glucometers to Diabetics) who is enlightened enough to be interested in mHealth and be considering the step change that is…

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Clinician Perspectives on Electronic Health Information Sharing for Transitions of Care

 "This report presents the results of a survey of clinicians about their needs and preferences regarding electronic health information: what type of information they want in various care transitions, how they would like to receive it, and how quickly. Their answers constitute invaluable data that will help both the public and private sectors plan, develop, …

ACOs – Is an EHR Enough?

ECG Management Consultants, Inc.

Accountable Care Organization

Since its inception in 2009 as a key piece of the Affordable Care Act, the goals of the accountable care organization (ACO) have been clear: provide timely, coordinated care; manage at-risk populations; and eliminate redundancy across the continuum. But while the goals may be straightforward, the best ways to implement an ACO are not.

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Trouble with EHR

Garlo Ward P.C.

Twila Braise at the Citizen’s Council for Health Freedom warns of eight hazards associated with EHR and its implementation.  They are:

  1. Dangerous Care
  2. Control of Doctors
  3. Increased risks for liability
  4. Data Breaches
  5. Hackers
  6. Government surveillance
  7. Broad sharing
  8. Detailed tracking

These should be considered by physicians wishing to remain independent in their practices in order to serve their patients and not the collective.

Go read the whole thing.

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Shadow IT: A Risk Proposition in Healthcare

The Pulse

The increasing use of technology in all aspects of healthcare creates many great opportunities as well as potential dangers.  Technology may open new avenues of care and facilitate the easier sharing of information among all providers participating in a patient’s care.  However, the same technology also presents the potential for sensitive healthcare information to be inappropriately accessed or exposed to public access, thus undermining the trust inherent in a provider-patient relationship.

Technology in healthcare can come in a number of forms too.  One common means are electronic health records (“EHR”) or electronic medical records.  Adoption of EHRs has been driven by government incentive payments.  The incentive payments subsidized, to an extent, the cost of acquiring and implementing the EHR for healthcare providers.  However, the rush to implement in order to take advantage of incentive payments resulted in systems that did not necessarily meet the needs of providers or take their…

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Getting Value from the EHR – Yes it is Possible

Navigating Healthcare - Patient Safety and Personal Healthcare Management

I have the privilege of spending a lot of time on the road interacting with clinicians around the country (and world). I hear with too much frequency many doctors complaining about the Electronic Medical Record and how it fails to help them and in many cases makes their work harder. Some of this is a hangover from the past and the inadequate technology and in some cases hardware at the time In fact I’ve told this story a number of times that I can date to around 1995/6 and in this piece: Clinical documentation in the EHR

Many years ago, an excited friend who worked for one of the electronic health record (EHR) vendors at that time — it was really more of a billing and patient tracking and management system than an EHR — was desperate to show me some of their latest applications. In particular, a new module…

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Narrowing down your EHR options

CureMD Blog

Adopting an Electronic Health Record (EHR) system is no longer an option, but an obligation. If your practice does not do so, you’ll be subject to penalties that will increase as time progresses.

Additionally, you will be deprived of the incentive payments that many of your competitors are benefiting from. However, with several hundred EHR vendors to select from, you require an EHR pricing and vendor comparison to make the right decision.

While the most important component of most decisions is price and costing, you still must develop an initial plan to determine which EHR vendor is appropriate including the how-much-will-it-cost-me component.

First you need to limit the number of vendors on your option base. For doing so, you will first need to identify several vendors based on your personal knowledge, market research and on recommendations of other physicians.

Look at the software and hardware their systems require. For example…

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