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Will Patients Accept The Patient Portal As “The Next Big Thing”?

There seems to be an inverse relationship between the amount of spin one hears about “the next big thing”…and reality.    First it was EMRs and virtual e-visits, then social media, and now patient portals seem poised to be next big thing.  The drumbeat of vendors and pundits is unmistakable….physicians that don’t adapt will be toast.   It can all sound pretty convincing until you ask to see the evidence.  What do patients think?

Take the physician patient portal.   If you read between the lines, patient portals are frequently being positioned as the new “front door” to physician practices.   By signing on to a secure website patients will have real time access to the electronic health record and will be able to communicate with their physicians by e-mail.   Additional patient features include being able to schedule an appointment with their doctor, reading their test results and refilling prescriptions.  But despite these features, according to John Moore at Chilmark Research, “nationwide use of patient portals remains at a paltry 6%.”

Ok… so now we know what vendors and pundits think about patient portals. What about patients – what do they think? Read more »

*This blog post was originally published at Mind The Gap*

An Alternative To A Colonoscopy?

Most of us born several decades ago, recall the futuristic book Fantastic Voyage by Isaac Asimov, where a miniaturized crew traveled through a human body to cure a scientist who has a blot clot lodged in his brain. Ironically, miniaturized medical care is now upon us while books are at risk of becoming obsolete.

I hope that gastroenterologists won’t become obsolete, at least until my last kid graduates from college.

I perform an amazing diagnostic procedure called wireless capsule endoscopy (WCE), when patients swallow a camera. Once swallowed, this miniaturized camera takes its own fantastic voyage through the alimentary canal. The test is used primarily to identify sources of internal bleeding within the 20 feet of small intestine, which are beyond the reach of gastroenterologists’ conventional scopes. I have performed over 200 of these examinations, and I am still awestruck when I watch a ‘movie’ of someone’s guts. While most examinations do not reveal significant findings, I have seen dramatic lesions that were bleeding before my eyes. WCE can crack a cold medical case wide open.

Here’s a typical view of the small bowel as seen by the cruising camera: Read more »

*This blog post was originally published at MD Whistleblower*

Anesthesia Medications Automatically Delivered During Surgery

A team of French anesthesiologists has developed an automatic delivery system of propofol and remifentanil, which they recently tested in a multi-center trial involving 196 surgical patients. The researchers reported in Anesthesia & Analgesia that the system, which uses a Bispectral Index (BIS) monitor as a guide, performed better than manual administration:

We have developed a proportional-integral-derivative controller allowing the closed-loop coadministration of propofol and remifentanil, guided by a Bispectral Index (BIS) monitor, during induction and maintenance of general anesthesia. The controller was compared with manual target-controlled infusion.

The controller allows the automated delivery of propofol and remifentanil and maintains BIS values in predetermined boundaries during general anesthesia better than manual administration.

 Abstract in Anesthesia & Analgesia: Closed-Loop Coadministration of Propofol and Remifentanil Guided by Bispectral Index: A Randomized Multicenter Study

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*This blog post was originally published at Medgadget*

IBM’s Watson Could Revolutionize Healthcare

If you’ve been watching Jeopardy! over the past couple days, you probably know that IBM’s highly-advanced artificial intelligence software, Watson, has been competing against Jeopardy!’s most successful contestants (and as of Tuesday night, took a commanding lead over the humans, despite having some trouble with United States geography).

Besides the amazing ability to power through “Daily Doubles” and answer random trivia in the form of a question, IBM researchers believe that Watson could revolutionize the healthcare industry. From diagnostics to informatics, Watson could quickly search through medical records, clinical documents, and research information for precise answers that would benefit both doctors and patients.

Check out the video below to see physicians explain how Watson’s technology could transform medicine.

Also watch the TED.com webcast of Dr. David Ferrucci (Principal Investigator of the DeepQA/Watson project at IBM), Dr. Herbert Chase (Professor of Clinical Medicine at Columbia University School of Physicians and Surgeons), and others discussing the Jeopardy! challenge and the impact the technology behind Watson could have on society.

More information on Watson from IBM…

*This blog post was originally published at Medgadget*

Managing Diabetes In “Real Time”

The cost of managing chronic diseases is the largest portion of healthcare expenditures in developed countries. For example, the prevalence of adult acquired diabetes has been rising in the United States, in concert with increasing rates obesity. The CDC has termed it an “epidemic,” especially in light of the massive costs incurred by the healthcare system due to diabetes.

The deleterious health effects of many chronic conditions can be diminished by behavior modifications. While few would underestimate the difficulty of having patients lose weight or exercise more, good management of blood sugar in diabetes is both objectively measurable and strongly correlated with reduced end-organ damage.

This is among the reasons why Research2Guidance has recently nominated diabetes as the condition most likely to be most targeted by mobile medical software and devices (mHealth). This finding is part of their recently published Global Mobile Health Market Report 2010-2015. This is the same report that also predicted that, in the future, medical apps are likely to be distributed by physicians and healthcare institutions.

This time Research2Guidance is highlighting the portion of the survey where they looked into where mobile devices have the most potential to affect health outcomes. While other chronic conditions such as hypertension and obesity have larger populations, the market researchers felt diabetes had the largest market potential due to the huge cost saving potential, the demographic and geographic overlap between smartphone users and people with diabetes, and the real potential to improve blood sugar management using mobile devices. Read more »

*This blog post was originally published at iMedicalApps*

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…

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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…

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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…

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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…

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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…

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