May 1st, 2009 by Dr. Val Jones in Expert Interviews
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I recently interviewed the CEO (Bill Reed) and SVP (Stuart Segal) of AllOne Health at the World Health Care Congress. Their enthusiasm for mobile technology rivals Better Health’s own Dr. Alan Dappen. Will mobile technology get people more engaged in healthy behaviors and assist with disease management? I hope so.
Dr. Val: What is “All One Health?”
Reed: All One Health provides a bundle of customized offerings to small employers – including insurance and health and wellness programs. We provide the same kinds of benefits that large insurers offer to large employers except we spend a lot of time analyzing the specific needs of small companies before initiating a health program for them. Some small companies have employees with diabetes-related challenges, and others might be more concerned about asthma. We also use predictive modeling (health risk assessments) to help the companies customize preventive health strategies for their employees.
Engagement and compliance are very important in bringing about substantive changes in healthcare – and good health can be incentivized by employers. All One Mobile is our means for connecting patients (or employees) with health coaches and nurses, which we believe is critical for affecting lifestyle changes.
Dr. Val: What does your “menu of services” look like from the employee’s perspective?
Reed: Each employee begins the relationship with a health risk assessment (HRA). That HRA recommends programs for the employee based on their risk factors, and prioritizes the top three things for them to work on. There are performance trackers linked to employer incentives for health improvements and the programs are available via the phone so that employees don’t have to be in front of their PC to interact with their health coaches. We have proactive outbound calling with an opt out feature. We believe that the mobile phone is critical for encouraging consistent participation in health programs. Our services center on phone-based reminders and personal relationships with coaches.
In the near future we’ll include blue tooth technology to have patients upload data from their home monitoring devices for their coaches to review. This is a more proactive approach to health management.
Dr. Val: And Stuart, tell me about the All One Mobile program for the Department of Defense (DOD).
Segal: The DOD was having difficulty with follow up care for military personnel returning from Iraq and Afghanistan with traumatic brain injuries (TBI). Once they returned to their communities, it was very hard to reach them. All One Mobile won a contract with the army to provide constant messaging services to soldiers with TBI because they need regular reminders to keep their rehabilitation on track. Army case managers can push out questionnaires to soldiers and depending on how they answer, the case manager might be triggered to give them a call while they have the phone in their hand. So the phone-based communication tool is the primary tracking device for soldiers who return to the US with TBI.
Dr. Val: What are the educational qualifications of your coaches?
Reed: Registered nurses, dieticians, and psychologists.
Dr. Val: And what if the patient needs to see a doctor?
The coaches are trained to refer patients to their doctor when it appears that they need it. We can also track their prescription patterns and send the patients a “gaps in care” letter to remind them to fill their prescriptions. Non-compliance with medications is a major problem that All One Health can address.
Dr. Val: How would a doctor use All One Mobile?
Segal: We’re currently working on making EMRs accessible via phones – so that no matter where a physician is, he or she can review patient records and track their progress remotely.
Dr. Val: Or better yet, when one doctor is taking call for her group, she can have access to patient records so that when she’s called in the middle of the night, she’ll be fully informed about the patient problem list and understand the context of the concerns much better.
Segal: Yes, and All One Mobile can be used in the Emergency Department setting – so that when patients are discharged home, they receive 30 days of our service. The hospital can send them their lab results (that were drawn in the ER) and easily contact patients to bring them back in if necessary. In addition the patients can take photos of their wounds, for example, and have the physicians see how they’re progressing.
Dr. Val: Any closing thoughts?
Reed: This kind of health communication is incredibly convenient. Patients don’t need to carry around a smart card, a thumb drive, or a paper record. They’re already carrying around what they need – their own cell phone. And almost everyone in the US, regardless of economic class or age, has a phone.
April 30th, 2009 by KevinMD in Better Health Network
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Why yes, you can.
From a German collection of 30 illustrations showing how you can die from electrocution. Uplifting.
(via kottke.org)
*This post was originally published at KevinMD.*
April 29th, 2009 by Stacy Stryer, M.D. in Uncategorized
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Yesterday I was sure that I wasn’t going to talk “swine.” Twelve hours ago I had almost, definitely decided on my topic. And it wasn’t swine flu. But sometime between then an hour ago, I changed my mind. I’m allowed to do that. It’s my blog. And, guess what. I changed it again.
I actually began to write about the swine flu but then took a break – for a very important reason. My sister, daughter and I had to start decorating hats for friends and family members who will join us this weekend to participate in the brain tumor walk in Washington D.C. Each year we form a team in memory of my husband, who died 4 years ago. As I was about to start writing my “swine” blog again, a friend and fellow team member emailed me to make sure that I pick up a “yellow” shirt for her tomorrow instead of a white one (when I pick up team members’ shirts for them), indicating that she is a brain tumor survivor.
This weekend always marks the beginning of two weeks of intense emotions. It begins with the brain tumor walk, moves onto the anniversary of my husband’s death in the Jewish calendar, then his birthday and, the day after that, the anniversary of his death in the common calendar.
This weekend also serves as a reminder of how important friends and family are. Each year I am amazed by the number of people who join me to celebrate my late-husband’s life and to support our family. While my children have to carry the burden of their father’s death, they also have learned how important life is and how lucky they are that so many people care about them.
It is difficult to know what to say when somebody becomes terminally ill or when a family member dies. What are the proper words? For the most part, it is not the exact words that matter. What does matter is that friends and family are there to show support. Immediately – and a week later. And 6 months later. And 2 and even 4 years later.
Some of my friends began to check on my weekly after my husband died and, to this day, still check on me the same day of every week. Others called me recently after a religious leader in my synagogue was diagnosed with the same type of tumor my husband had – because they wanted to make sure I was doing OK. Likewise, my daughters’ friends, who are now 5th graders, watch out for her. When a classmate’s father recently died, it upset my daughter greatly. That evening I received several phone calls from her friends’ parents, who had heard she was very sad. I also received a phone call from her guidance counselor, letting me know about the death and making sure my daughter was OK.
We have over 65 people walking with us this Sunday. Our team is comprised of aunts, uncles, in-laws, and cousins. It also include teachers, a principal, and an old patient of mine. Plus, there are friends of my husband’s, good friends of mine who barely or never knew him and, of course, old and new friends of both of my daughters. Some didn’t even know my daughters when their dad was alive.
I will keep my fingers crossed that most of the people walking this Sunday are accompanied by someone wearing a yellow shirt, rather than just a sea of white.
April 29th, 2009 by Paul Auerbach, M.D. in Better Health Network, Health Tips
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In continuing with the theme of getting ready for the beach and water sports this summer, let’s consider what to do about substance abuse. There is no controversy whatsoever about the fact that persons under the influence of alcohol or any other mind-altering substance have a higher incidence of accidents. In fact, ingestion of alcohol figures prominently as a statistic in falls, drownings, motor vehicle accidents and virtually every variety of activity that has ever been studied. The issue, then, is not whether or not alcohol contributes to illness and injury, but to what extent we are able to control its use by reason and, when necessary, prohibition.
Im June of 2008, Solana Beach, California banned alcohol consumption on its beaches for at least a year. This ban continues. Here is what appears on the city’s website:
Alcoholic Beverages – Alcohol is banned at all beach areas in Solana Beach. Alcohol is also prohibited in the parking lot, community center, viewpoint or any other public place adjacent to the beach. Glass is prohibited as well.
There are similar rules at, among others, Torrey Pines State Beach, Cardiff, San Elijo, South Carlsbad and Carlsbad state beaches.
City officials made this move proactively, to avoid the sorts of tragedies and social problems that have intermittently plagued “wet” beaches. Recognizing that judgment is often an irrelevant factor when it comes to drinking alcohol, they made a strong and, in my opinion, laudable move. Like it or not, judgment is impaired by drinking alcohol, so the concept of “responsible drinking” is an oxymoron when water sports and potentially hazardous surf conditions coexist with beer, wine, and liquor. Of course, the same is true for certain prescription drugs and illicit drugs.
Needless to say, civil libertarians and numerous other individuals are opposed to mandated prohibitions. They cite lack of observation of problems, principles of freedom and personal rights, and even the loss of romanticism. The issue obviously has two sides.
From a safety perspective, it’s a no-brainer. There’s no benefit to drinking alcohol and entering the ocean. It can never make you safer, and can only make you less safe. Even if you are able to drink alcohol at the beach and safely dispose of your metal cans and glass bottles, not litter, not be rowdy or obnoxious, and keep your drinking to yourself, the moment you dip a toe, you are a greater risk to yourself and to the lifeguards and other rescuers entrusted to protect you. You may not believe that to be the case, but the stories and statistics don’t support you. Having pulled intoxicated victims from the water, treated them at the scene, stitched their heads and set their broken bones in the emergency department, and having had to tell their families and friends that they are dead (while knowing that none of this would have ever happened had the victims been sober), I am offering well-intentioned advice. Not every city will mandate that you leave your beer cooler at home when you head to the beach. When you need to be the one to decide, choose wisely.
Preview the Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 24-29, 2009.
Join me from January 24 to February 2, 2010 for an exciting dive and wilderness medicine CME adventure aboard the Nautilus Explorer to Socorro Island, Mexico to benefit the Wilderness Medical Society.
photo courtesy of www.aquaticsafetygroup.com
*This post, Alcohol At The Beach, was originally published on Healthline.com by Paul S. Auerbach, MD, MS.*
