Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Which Doctors Use More Digital Widgets? Hint: The Same Ones Who Play(ed) Video Games

This news flash from the land of no surprises… The Journal of The American Medical Informatics Association recently published a study analyzing physician use of online technology. They hypothesized that certain types of physician specialists (such as dermatologists?) would display higher adoption rates of Internet-based communication technology (including things like social media platforms, podcasts, health apps, and widgets). But instead they discovered that adoption of these technologies was correlated with male gender, younger age, and practicing medicine in an academic hospital setting. In other words, young geeky dudes are the ones who are most likely to use techie medical widgets. Who’d have guessed?

All kidding aside (and in case you hadn’t noticed, I’m a middle-aged, female physician who does not practice medicine in an academic setting. I have a blog, a podcast show, and was recently rated one of the top 10 MDs to follow on Twitter – so I must be a serious, category-blowing geek), this does have implications for healthcare. First of all, according to the US Department of Labor, ~80% of family healthcare decisions are made by women, and we consume a disproportionate amount of healthcare resources too. So in my opinion, healthcare technologies should be built by/for women and marketed to them more aggressively. Because if we’re trying to drive adoption of these things to streamline care, facilitate access, and reduce utilization, then we’ve gotta get the ladies on board too.

This study only confirms to me that we’re not there yet – guys are still more likely to use health apps/widgets, etc. But just as “progress” has been made in the video gaming industry (where only 12% of gamers were girls in 2001, that has grown to 40% in 2009) I think we can make similar gains in healthcare. And it’s for a much better cause than “getting really good at playing Grand Theft Auto.” Health apps have the potential to help people manage their diseases and conditions, avoid unnecessary trips to the doctor, and get them to the right healthcare provider at the right time.

So all you geeky (I say that with the utmost respect as a geek myself of course), male software developers out there – please befriend a few female physicians and work with us to get the tech trends moving in the right female direction. We’re all together in this game of life, right? 😉

Ways To Increase The Number Of Women CEOs In Health IT

The appalling lack of women chief executives in today’s Health IT companies has been linked to a paucity of women in IT generally and the scarcity of female mentors and venture capitalists that could support them. Social norms regarding gender identity and child rearing also drive the disparity. In this post, I’ll briefly review these norms and some promising efforts to reduce the disparity.

Social Norms, Women and Tech
Many people believe social norms and expectations regarding women are the most important reason why there are so few female IT leaders out there today. As the father of 3 girls who are succeeding in tech, I don’t necessarily agree with this (I think the phenomenon is driven by these factors).

Still, there are some indisputable facts that have to be mentioned. Read more »

*This blog post was originally published at Pizaazz*

Advice From The EMR Trenches

The latest from moi: “Implementing Electronic Medical Records: Advice from the Trenches” in the March/April 2011 issue of HIT Exchange magazine. An excerpt:

The news released in late December from the Centers for Disease Control and Prevention that more than half of the nation’s physicians are now using electronic medical records (EMR)—double the adoption rate of just five years ago—is surely worth celebrating. Until, that is, you take a look and realize that just a fourth of office-based physicians have access to a “basic” EMR system including patient history, demographics, problem lists, clinical notes, and computerized physician order entry (CPOE), while just one in 10 has a “fully functional” system, which also includes the communication system required for meaningful use, such as the ability to send tests and prescriptions electronically.

But the floodgates are about to open. In January, the Centers for Medicare & Medicaid Services (CMS) began registering physicians and hospitals in 11 states for the EMR incentive program announced in 2009 as part of the federal stimulus package. Registration for California began in February, and the rest of the country should be up and running by the end of the year. Physicians could be eligible for up to $44,000 in bonuses over five years through Medicare and up to $63,750 over six years through Medicaid.

*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*

You Are “The Biggest Wasted Resource In Health Care”

ABCNews.com has posted a great new piece by Dr. Roni Zeiger entitled, “The Biggest Wasted Resource in Health Care? You.” Subtitle: “How Your Internet Research Can Help Your Relationship With Your Doctor.” It’s well reasoned and clearly written, and continues the trend we cited a month ago, when Time posted Dr. Zack Meisel’s article saying that patients who Google can help doctors.

Related notes:

— Dr. Zeiger’s article title parallels what Dr. Charles Safran told the House Ways & Means Subcommittee on Health in 2004: Patients are “the most under-utilitized resource.” He was talking about health IT, quoting his colleague Dr. Warner Slack, who had said it many years earlier. I often quote it in my speeches for the Society for Participatory Medicine, asserting that it applies not just to IT but to all of healthcare.

— Dr. Zeiger is on the editorial board of our Journal of Participatory Medicine and is Chief Health Strategist at Google. He gets the power of patient engagement deeply and clearly. Last fall he posted a prediction that in the future it might be malpractice for doctors not to prescribe a patient community to help you help yourself with your conditions.

Prediction: Googling and patient networks will become essential as we move toward the practice of shared medical decision making (SMDM). I know firsthand that the information my kidney cancer community gave me about coping with treatments went well beyond what my excellent clinicians could offer. (We’re starting a series on SMDM. The first entry was in December.)

*This blog post was originally published at e-Patients.net*

A Doctor’s Brain: The Most Important Piece Of Healthcare Technology

Some people may tell you that healthcare IT will solve many of the quality and cost problems in healthcare. I don’t believe them.

I know a 70-year old man named Carlos (not his real name) who was hospitalized following a bout of hydrocephalus. Hydrocephalus is a build-up of fluid in the skull, which affects the brain. Among other things, people with hydrocephalus can be confused, irritable, and nauseous. Carlos had all of these symptoms.

Carlos’ problem was fixable by inserting a special kind of drain in his head called a “shunt.” This kind of shunt is, essentially, a series of catheters that runs from the brain into the abdomen, and which drain the excess fluid. You can’t see it from the outside, so it’s meant to stay inside of you for a very long time.

For a week after Carlos’ shunt was installed, his symptoms completely disappeared. But they soon started to re-emerge. Worried, his family took him to the hospital. Doctors found that his hydrocephalus was back — the shunt wasn’t draining properly. They admitted him to the hospital, and the next day they put in a new shunt. The surgery went well.

But again, about a day later, he started to have the same kinds of symptoms. The doctors sent him for a CT scan, which showed, to their surprise, no problems with the shunt. Unsure of what to do, they decided to wait and see if the symptoms resolved. It was possible, they thought, that the symptoms were from the quick drainage of fluid through the shunt. Read more »

*This blog post was originally published at See First Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles